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435652 tn?1204315393

Ovary Size Difference & Cyst(s)


I was wondering a few things. First, if it is normal to have ovaries that are a different size (10 days after first day of menses).

For example my left ovary measures: 2.9 x 1.3 x 1.8cm, my right ovary measures: 4.7 x 3.1 x 3.0cm.

Additionally, in July I had an ovarian cyst which measured 14mm. I was told to have a follow-up after menses in which I did, and at that time it was approximately 3cm (this was in October). In November (10 days after first day of menses) the cyst measured: 4.5 x 2.6 x 2.6 cm.

In the past I was diagnosed via Laparoscopy and biopsy of several small uterine masses as having Endosalpingiosis. I was wondering if perhaps this cyst could be related to this diagnosis. Furthermore, I understand that birth control can assist in shrinking cysts, but I was on it while this cyst was forming and taken off after 6 months of treatment due to blood clots and excessive bleeding (I had a 3 month cycle with no breaks).

My final concern is if this cyst can rupture. I cannot have children due to a damaged fallopian tube from an ectopic pregnancy (I had a tubal ligation per my GYN's advice to avoid another ectopic). I'd like to eventually get IVF but can't for some time as I'm currently being treated for a few Infectious Diseases (TBD's) I picked up whilst rock-climbing and I'm still researching one that could possibly be recurring (Babesia - sero-positive) and also figuring out if a past PVB19 infection can be passed in-utero (Positive Parvovirus IGG @ 5.01 IV - if that matters). My GYN told me the cyst would go away "on it's own in time" but I don't really entertain the idea of risking my ovary as eventually I'd like to put it to use. If it will go away, or if it can't rupture I am OK with that. Sadly, he hasn't returned my call or my PCP's call in over a month (he's a busy fertility specialist).

Any feedback would be appreciated, and I apologize for typing so much. I like to be descriptive when able.


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242596 tn?1192429549

The size of ovarian cysts do not have to be symmetrical.  The sizes you report are within normal limits.  With regard to ovarian cysts, there are many different types of cyst.  What you describe sounds like a physiologic cyst or the cyst that forms leading up to  and following ovulation.  This is called the dominant follicle prior to ovulation and the corpus luteum after ovulation.  The best time to have a pelvic u/s to avoid calling a normal cyst something else is a few days after the onset of menstruation.

High doses of oral contraceptive pills leads to the suppression of ovulation and thus theoretically to the prevention of cyst formation.  However, in the present day pill formulations, the hormone levels are not high enough to reliably accomplish this.

Yes, cysts can rupture.  There is no way to predict this, but when they do it would be highly unlikely for that to require removal of the ovary.  

Lastly, a prior parvovirus infection (P19 IGg+) will not affect a future pregnancy or IVF.

Best regards,

Dr. Downing
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