What is ovarian chocolate cyst? Ovarian chocolate cysts, also known as ovarian endometriosis cysts, is a disease caused by the endometrium “migrating” to the ovaries, and it is the most common type of endometriosis. It is the most common type of endometriosis. When menstruation occurs, the ectopic endometrium in the ovaries also bleeds like “menstruation”, and the “menstrual blood” cannot be expelled from the body, so it is retained in the ovaries. As the blood inside the cyst is old blood that has been retained for a long time, it has a chocolate-like appearance and is therefore also known as “ovarian chocolate cyst”. “Because the blood inside the cyst is old blood that has been retained for a long time and has a chocolate-paste appearance, it is also known as an ovarian chocolate cyst, also known as a coarctation. About 80% of patients with ovarian chocolate cysts have lesions involving one ovary, and 50% of patients have bilateral ovarian involvement. Do ovarian chocolate cysts always cause menstrual pain? As we all know, the typical symptom of endometriosis is progressive dysmenorrhea, and is ovarian chocolate cyst, a type of endometriosis, also associated with dysmenorrhea? The answer is: patients with ovarian chocolate cysts may not have dysmenorrhea! Menstrual pain or chronic pelvic pain or painful intercourse will not be present unless there is a combination of other endometriotic lesions. Can ovarian chocolate cysts cause infertility? Patients with endometriosis have an infertility rate of up to 40%, and of the infertility cases, about 80% have ectopic disease. Therefore, patients with ovarian chocolate cysts may experience infertility or a decreased chance of conception. However, there is no need to be too nervous, as it is not absolute infertility and a healthy baby can still be born after appropriate treatment. What should I do if I am pregnant and found to have ovarian chocolate cysts? It is hard to get pregnant, but the ultrasound suggests the possibility of ovarian chocolate cysts, and you are happy with a burst of anxiety inside. If the cyst is <125px, close ultrasound follow-up is recommended and happily, pregnancy actually has an inhibitory effect on chocolate cysts. So there is no need to be particularly worried, do regular maternity checkups and seek prompt medical attention if there is significant abdominal pain or vaginal bleeding. If the cyst is ≥125px, then surgery is still considered to prevent the risk of cyst rupture or torsion, etc. The timing of surgery can be chosen to be more appropriate at 14-16 weeks of pregnancy. How soon can I get pregnant after ovarian chocolate cyst surgery? For young patients with fertility requirements, after chocolate cyst debulking (laparoscopic surgery is usually recommended), active pregnancy preparation is recommended! Some patients may ask if they need to repair the surgery for a while just after the surgery. The answer is no, six months after surgery is the best time to conceive! The best time to conceive is six months after surgery! You can also consider giving GnRh-α medication for 3-6 months after surgery, which can reduce recurrence and prolong the recurrence time, and then you can prepare for pregnancy when you stop the medication and resume menstruation. Can TCM treat ovarian chocolate cysts? In Chinese medicine, ovarian chocolate cysts belong to the category of "Y obstruction", and the pathogenesis is stasis of blood, so the principle of treatment is to activate blood and remove blood stasis. Since the occurrence of this disease is related to menstrual cycle, the treatment should be based on the different physical conditions of menstrual cycle, based on examination, diagnosis and diagnosis, and evidence-based treatment. Generally, before menstruation, the main treatment is to regulate qi and eliminate stasis; during menstruation, the main treatment is to activate blood circulation and eliminate stasis, regulate qi and relieve pain; after menstruation, the main treatment is to benefit qi and tonify kidney, activate blood circulation and eliminate stasis. Oral Chinese medicine can also be taken after surgery to prevent recurrence.