Cyst aspiration

I have a cyst on my left ovary that my RE has been monitoring for two months. This last ultrasound showed tissue starting to surround it. Thought to be endometric tissue. They feel that it is safe to aspirate.  I have told them my concern that my Aunt had ovarian cancer at age 23 (I am 30) and they said they believed it to be fluid filled.

My questions is, should I be worried or seek a 2nd opinion? What would be your diagnosis with the information given. I have heard mixed stories about aspiration. If it is cancerous it would be likely to spread the fluid through out my body. I am just very confussed. Once we get this taken care of we will start IUI. Please advise.

[USF-M.D.-JM]

I can only answer this question, in the way I would treat a patient, there is more than one way to evaluate and treat this situation. First the sono is very relevant, does the cyst look simple, smooth wall, there is a whole language of sonogram, but does it look benign. We can't dismiss your family history but this is the exception to the rule, to be 23 and get ovarian cancer. I usually wait 3 months for the cyst to go away. Just draining is a difficult call, the fluid usually comes from the wall of the cyst and just draining it and leaving the cyst wall behind allows it to come back and we are starting over. If you do drain it what does the fluid look like?
I would give it 3 months, place patients on birth control pills ( not because they make cyst go away but they suppress the ovary) a benign cyst usually resolves and goes away, if it remains present, laporocopy/ cyctectomy. Sounds aggressive but not really, 30 years old with a cyst that does not resolve, I question, not so much cancer but benign pathology, endometrioma, paratubal cyst, etc....
Hope this helps
JM