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Ovarian Cysts And Controlled Ovarian Hyperstimulation (Coh) with Gonadiotropins
by Geoffrey Sher M.D.
“Functional ovarian cysts” are literally nothing more than ovarian follicles that have become enlarged, dilated and distended with fluid However, they acquire special relevance when detected in women about to undergo controlled ovarian hyperstimulation COH) with gonadotropins where they can literally, “throw a spanner in the works”, causing a slight delay, postponement and sometimes even a cancellation of the cycle of treatment.
Aside from causing menstrual dysfunction such as a delay in the onset of menstruation or irregular cycles, they are usually non-symptomatic. In some case, these “cysts” will undergo rapid distention (often as a result of a minor degree of bleeding inside the cyst itself) and the woman will experience a sharp or aching pain on one or other side of her lower abdomen and/or deep seated pain during intercourse. Rarely, these “functional cysts” rupture, causing sudden onset of severe lower abdominal pain, which may simulate an attack of acute appendicitis or even a ruptured ectopic (tubular) pregnancy. While very unpleasant, a ruptured “functional cyst” hardly ever produces a degree of internal bleeding that warrants surgical intervention. The pain, which is worse on movement, almost always subsides progressively over a period of four to five days.
DISTINGUISHING BETWEEN “FUNCTIONAL CYSTS” AND OVARIAN TUMORS
Ovarian cysts may be "functional” or "cystic tumors". “Functional cysts” grow in response to a sustained elevation in blood levels, of luteinzing hormone (LH) and/or follicle stimulating hormone (FSH). On the other hand, “cystic ovarian tumors”) are capable of independent growth and do not require gonadotropin stimulation. This is what distinguishes them from "functional" ovarian cysts. It follows that "Functional ovarian cysts" may develop as a result of non-physiological, sustained pituitary gonadotropin stimulation or as a result of prolonged administration of gonadotropins (e.g. Follisim, Gonal F, Humegon, Pergonal and Repronex.