Suspected endometrioma

[ZoeQ90]

TW: MC

TLDR: suspected endometrioma but no other signs of endometriosis. Have been pregnant but miscarried between 7-10 weeks. Concerned what the cyst/endometriosis might mean for my fertility.

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I had a scan to confirm miscarriage and it also found a cyst on my left ovary. It's since been checked and is 7.1cm and thought to be an endometrioma. This can't be confirmed without surgery.

I was completely surprised by this result and didn't ask as many questions of the sonographer or my doctor as I should have. I'm now a little...confused?

Firstly, I believe if it is an endometrioma this means I have endometriosis and either stage 3 or 4 which are more serious. I've had no symptoms, no pain and very regular periods. My doctor said this is relatively common when cysts are an incidental finding. It's just odd to be told you have a disease which associated with such pain and difficulties but to have had no symptoms.

She said it shouldn't really affect my fertility and that I've already got pregnant proves this. However, my online reading (I know, I know, this isn't ideal), suggests that endometriosis and especially stage 3/4 can impact fertility, quite seriously sometimes. Especially when it's on an ovary.

I'm also concerned about the size, which seems to be heading into the zone where removal could be considered, although I'm not sure what the deciding factors for this are. I guess if I were in serious pain or if it is compromising my ovary.

I don't really know what my next steps should be, what questions to ask or even if I should be worried at all.

Hey lovely lady,

Just wondering if you had any updates? I think I've just been diagnosed with the same thing, after i had a miscarriage at 6 weeks. I hope you're doing OK x

I am so sorry about your miscarriage.

It's not odd that it was an incidental finding. Endometriosis is a variable disease, some with symptoms, others without and severity of disease does not always dictate symptoms. Also, "stage" is merely to relay the appearance/distribution of endometriosis amongst physicians, and does not necessarily telling you anything else. Similarly, not everyone with endometriosis is infertile, but endometriosis may be over-represented in the infertile population. Age and other factors play a big role in fertility.

Ask them how often to monitor the endometrioma, and whether you should remove it given size. I had an endometrioma a little over 4cm removed and got my first pregnancy 1 mo later (after 2 years TTC). Fertility doc said not to remove it due to risk of losing ovarian reserve and my age (36 at the time), but I decided to as I had a friend with a similar situation and ended up having 2 kids naturally after its removal. Unfortunately lost him at 12 weeks in 9/2022 and still TTC. So not clear if it was a coincidence/chance or related to the surgery.

Thank you very much for sharing, I'm sorry to hear about your loss too, sending you hugs. I've got another scan in a few months so will ask then. Thank you 💗