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Korean Journal of Fertility and Sterility 1989;16(1):57-68.
The Efficacy of Estrogen-Progesterone Therapy and Transvaginal Aspiration of Ovarian Cysts
SY Moon, SH Kim, TY Hwang, CJ Shin, JG Kim, JY Lee, YS Chang
Department of Obstetrics and Gynecology, College of Medicine, Seoul National Univeristy
난소 난종 환자에서의 Estrogen-Progesterone 치료 및 질식 난소 낭종 천자에 관한 연구
문신용, 김석현, 황태영, 신창재, 김정구, 이진용, 장윤석
서울대학교 의과대학 산부인과학교실
Abstract
Some infertile patients who need IVF-ET for conception have small ovarian cysts diagnosed in pelvic ultrasonography. It is well known that it is impossible or very difficult to perform controlled ovarian hyperstimulation(COH) for such patients because of the poor ovarian response or the possibility of ovarian hyperstimulation syndrome(OHSS). To remove or to decrease the size of ovarian cysts, estrogen and progesterone (E-P) therapy with oral contraceptives for 2 cycles and transvaginal aspiration of ovarian cysts using transvaginal ultrasonography were performed in 36 IVF-cancelled infertile patients with ovarian cysts from February to October, 1988 at Seoul National University Hospital. Thirty-nine ovarian cysts($32.8{\pm}9.6$mm in mean diameter) were treated with E-P therapy, and their size decreased to $28.2{\pm}11.0mm$ after 1 cycle and significantly to $24.8{\pm}14.7mm$ after 2 cycles. After E-P therapy for 2 cycles, 7(17.9%) ovarian cysts disappeared in ultrasonography, 9(23.1%) decreased in size significantly, 18(46.2%) had no change in size and 5(12.8%) increased in size. Thirty-two ovarian cysts($30.2{\pm}9.7mm$) in 30 patients were aspirated transvaginally, and there was no significant decrease in size after follow-up transvaginal ultrasonography($27.8{\pm}12.5mm$). After transvaginal aspiration, 3(9.4%) ovarian cysts disappeared and 28(87.5%) had no change in size. The mean amount of the transvaginally aspirated cystic fluids was $19.6{\pm}13.2ml$, and there was no malignant cells in aspiration cytology. Four endometrioid cysts, one dermoid cyst and one mucinous cyst could be diagnosed in consideration of the findings of transvaginal ultrasonography and the characteristics and cytology of aspirated fluids. Therefore E-P therapy and transvaginal aspiration of ovarian cysts had made it possible to restart IVF program earlier in the IVF-cancelled patients with ovarian cysts.


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