Should you leave or remove the ovary with Endometrioma?
I have a big lesion on my left ovary. A surgeon has told me they can keep the ovary with a high risk of recurrence or remove it and leave me with only one ovary on the right side. What would be your consideration if you were in this situation?
I had one ovary removed and I had one ovary that had less destruction but some endometriomas and my expert endometriosis surgeon operated on it and removed as much as she could. She said, there might be microscopic endometriomas that she couldn’t see to remove so there’s a chance it could grow back but she would leave the one ovary so that I could get through menopause with my natural hormones. Because menopause sucks.
It’s been over a year since my surgery and my hormones never really came back to producing a good amount of estrogen. I still went through surgical menopause . I am now on hormone replacement therapy. If I had known that I would still need to use hormone replacement therapy, then I’m not sure that I would have left the ovary at all because now I have the risk it could grow back. I hope that helps.
- Erika Engel answered 1 year ago
- last edited 1 year ago
I had a hysterectomy for adenomyosis along with complete excision for stage 4 endo in October 2021. Within 8 weeks of my surgery, my multi cystic ovary developed an endometrioma. For now, we are monitoring it, but once the endometrioma grows or causes pain, I’ll have the ovary removed so this doesn’t happen again. This will leave me with one ovary that will hopefully stay healthy enough to sustain me until menopause. Im 31
I agree with some of the comments in that I would definitely seek out additional surgical opinions – with surgeons who have completed a fellowship in Minimally Invasive Gynecologic surgery AND who have at MINIMUM 5 years endometriosis surgical experience since completing that fellowship. (Preferably 10 years.) I would not be surprised if the surgeon who made the recommendation to this patient is an OB/GYN or more general gynecologist/surgeon (or even general or oncological surgeon), who are taught different and (in my opinion) far less helpful approaches to operate on endometriosis patients. In my personal experience as a patient and in my own research, I’ve come across multiple surgical techniques to remove endometrioma from ovaries. So, if this doc isn’t even discussing the range of options and how/why each could be helpful, sounds like opinions with surgeons who have different training would be really helpful in making an informed decision about treatment options.
I chose to keep both ovaries, although one had a large endometriosis and one was adhered to bowel with endo. I had 2 nearly pain free years, but am struggling again. TBD if endo is back or if something else is going on. In hindsight I wish I’d been less conservative in my first surgery. Early menopause is scary without a plan for support from a great care team, though!
I had a 4 cm endometrioma on my left ovary. Prior to surgery the plan was to keep as much as possible but take whatever needed to go. I have all reproductive organs in tact and was able to conceive almost 2 years post op with the help of letrozole to boost ovulation.
I had 9 cm endometriomas on each ovary. My surgeon excised the lesions and saved my ovaries in hopes of preserving my fertility. A year after my surgery, we got 16 eggs and ultimately 6 normal embryos. I’m sure my surgical outcome would’ve been different if the goal wasn’t fertility preservation.
I had a 17cm endometriosis on my left ovary 3 years ago which was excised. My doctor saved my ovary and I had a beautiful baby girl 2 years later 🙂 if you really want kids or think you will think about your options. I conceived my baby girl from my left ovary and am so glad my doctor didn’t just cut it out.
I had a similar situation. I was on luprodex injection prior to surgery. The size of the endometrioma reduced to an extent and the doctor saved as much healthy tissue could be saved instead of removing the left ovary. It’s been five years. I have no recurrence so far in the left ovary. However, I have endometriosis in right ovary now, which we are monitoring and I am also on dienogest.
I would leave my ovaries but I also understand why others wouldn’t. Basically all I care about is that the choice is left to the patient, without any shame. I was informed by my doc that if I were to get a hysterectomy they’d remove my ovaries by default which absolutely terrified me and made me want to switch doctors. The decision should be the individual’s, cause the body is theirs
for example I don’t care about fertility and in fact I’m happy endo takes it away, it’s like a natural bc. I would be utterly p1ssed and probably sue if they took my ovary without my permission to save my fertility, because oopherectomies can have horrendous side effects, for example weight that’s very hard to lose
My first endo surgery was don’t by my fertility specialist who just drained the endometriomas and removed a very small piece of each ovary. My endometriomas grew back within about 6 months. We won’t on to do IVF with endometriomas on my ovaries and none of our embryos stuck. They endometriomas are now at 16.5 and 7.5cm and I have found an endo specialist who is able to remove the endometriomas without damaging my ovaries, so that’s what I’m going with this time. Hoping this helps and allows us to have a baby
From what I have researched, the recurrence rate depends significantly upon surgeon skill.In my case, I did a ton of research and settled on a surgeon with a ridiculously low recurrence rate due to skill, and not only saved but reconstructed, both of my ovaries. Hormonal imbalance have greatly perturbed my life for 20 years and removing an ovary would only worsen that.