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Ovarian Endometriosis

Image including difference between Normal uterus vs Globular adenomyosis uterus

Ovarian endometriosis, often referred to as a “chocolate cyst,” is the most common form of endometriosis.

This condition can occur in isolation or be associated with deep endometriosis and endometriosis in various extra pelvic locations.

Ovarian endometriosis is known to play a significant role in causing infertility, affecting approximately 20-40% of patients with endometriosis.

Ovarian endometriosis is also associated with severe pain, regardless of the cyst’s size. However, it’s not uncommon to see large endometriomas causing no pain.

However, the relationship between ovarian endometriosis and pain is not always straightforward. It’s possible for severe pain to accompany even small-sized cysts, while large endometriomas may exist without any pain.

Typically, ovarian endometriosis is bilateral, leading to what’s commonly referred to as “kissing ovaries.”

These can occur in various sizes and often associate with deep endometriosis. However, isolated and unilateral cases of ovarian endometriosis may also occur.

Symptoms & Diagnosis of Ovarian Endometriosis

Ovarian endometriosis usually presents with chronic pelvic pain, dysmenorrhea, and dyspareunia. Some women may experience irregular menstrual cycles, heavy bleeding, or even infertility.

It’s important to note that the severity of symptoms doesn’t always correlate with the extent of the disease; some women with extensive endometriosis may remain asymptomatic.

For diagnosis of ovarian endometriosis, it involves a combination of clinical examination, imaging techniques, and, at times, surgical intervention.

Transvaginal ultrasound is typically the first-line imaging modality due to its wide availability and excellent sensitivity.

Magnetic Resonance Imaging (MRI) serves as a more precise tool for detecting deep infiltrating endometriosis. Ultimately, a definitive diagnosis can only be established through laparoscopic surgery and histological examination of the excised tissue.


Dr. Jay Mehta and his colleagues follow a stepwise protocol resulting in 85-90% accuracy in endometriosis mapping, which requires a high level of expertise.

Dr. Jay Mehta is a renowned fertility specialist with extensive experience, expertise in endometriosis treatment & the results he has shown. He is considered one of the top endometriosis doctors in Mumbai.

When Surgery is Needed for Ovarian Endometriosis

For small ovarian endometriomas, especially those smaller than 3cm, medical management in the form of continuous oral contraceptive pills or dienogest is typically recommended.

Patients are kept on a 6-month follow-up to monitor the disease progression.

Surgery is typically indicated for ovarian endometriosis larger than 5 cm, or if the endometrioma is multiloculated or multicystic. Severe pain associated with ovarian endometrioma is another indication for surgical management.

 

The ideal surgical approach for treating ovarian endometrioma is laparoscopic surgery, considered the gold standard for diagnosing and treating endometriosis.

A well-performed laparoscopic surgery, especially in 3D, gives the doctor an excellent depth perception of the disease in the pelvis, ensuring complete disease clearance and minimal recurrence post-surgery.

One of the most common mistakes patients make is opting for a non-specialized surgeon for their first endometriosis operation. Unfortunately, this can lead to the need for a second surgery performed by an expert.

By this time, fertility may already be compromised due to poor surgical technique in the initial procedure. It’s important to choose a surgeon with expertise to ensure the best possible outcome.

It’s absolutely crucial to never underestimate the impact of choosing the right doctor for endometriosis treatment. It can make a huge difference.


Dr. Jay Mehta and his team operate more than 500 cases of Endometriosis across India annually. Dr. Jay is a very experienced fertility & endometriosis specialist in Mumbai.

Book Your Consultation Today With an Ovarian Endometriosis Specialist in India – Dr Jay Mehta

Post Surgery, Recurrence & Fertility

Post-surgical medication is often necessary, especially in cases where patients are young and marriage plans do not exist.

To prevent recurrence, especially in cases of multilocular ovarian endometriomas, long-term oral contraceptive pills may be considered.


About fertility after surgery,

An AMH test is strongly recommended before surgery. Post-excision, the AMH level typically drops for the initial 6 months after surgery but usually recovers after that period.

To avoid permanent ovary damage, it’s crucial that an expert performs the surgery, especially when preserving fertility.

Why?

Surgery for ovarian endometrioma can affect future fertility.

Incorrect surgery for ovarian endometrioma can compromise fertility in young girls. Therefore, it’s wise that a specialist treats ovarian endometriosis to conserve fertility, especially in young women.


While many women choose to delay fertility and marriage, it’s important to counsel them about the temporary reduction in AMH following endometriosis surgery.

Early marriage and not postponing fertility is often advised because pregnancy provides the best medical management for endometriosis.

However, it’s vital to note that pregnancy does not cure endometriosis.

Also,

Egg freezing is a valuable option for women undergoing surgery to ensure sufficient frozen egg reservoirs.

Women are typically advised to freeze 12 to 16 eggs post-surgery to maintain their fertility potential.

The procedure usually begins 1-2 months after the surgery, and patients should be thoroughly counseled about this option prior to the surgery.

In conclusion, managing ovarian endometriosis requires meticulous planning and expert intervention, particularly when preserving fertility is a concern.

Decision-making should be individualised, taking into consideration the woman’s age, severity of the disease, and desire for future fertility.

Pre-surgical counseling about potential AMH reduction and the benefits of egg freezing is essential.

Despite the challenges, with the right approach, women with ovarian endometriosis can maintain their fertility and improve their quality of life.

For any endometriosis treatment in Mumbai, consider seeking a consultation with Dr. Jay Mehta. He is highly experienced and can provide the necessary expertise to address your specific concerns.

Dr. Jay Mehta Fertility and IVF Specialist In Mumbai

Dr. Jay Mehta

MBBS, DNB – Obstetrics & Gynecology
IVF & Endometriosis Specialist, Laparoscopic Surgeon (Obs & Gyn)

4.9

Verified & Most Trusted One

Dr. Jay Mehta is a renowned IVF specialist and fertility-preserving surgeon in Mumbai, India. He is the Director of Shree IVF and Endometriosis Clinic, as well as the Director of Uterine Transplant in Global Hospitals, Mumbai. He is a leading laparoscopic gynecologist in India for endometriosis and adenomyosis..

He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology. He operates India’s major cities including Mumbai, Pune, Chennai, Hyderabad, Bangalore, Ahmedabad, Agra, Delhi etc.

To book an appointment, call: +91 - 9920914115 or fill out our contact form

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Ankita Katyal

I am incredibly grateful for Dr. Jay's exceptional support throughout my IVF journey. Dr Jay has been like God sent an Angel for us. From our very first meeting, it was clear that Dr. Jay was not only a highly skilled and knowledgeable professional but also someone who genuinely cared about my well-being.

From my first meeting, he was very clear transparent, and straightforward about my protocol, treatment line, and success rate. After two difficult IVF cycles that failed, I was beginning to lose hope.

However, Dr. Jay’s unwavering encouragement and meticulous care helped me stay positive and focused. Thanks to God and of course to his expertise and dedication, WE FINALLY ACHIEVED SUCCESS!!!!!

Krish A

Dr Jay Mehta is the best Fertility doctor. I am glad to have IVF done with Jay sir.

This unit is very ethical and very honest at work. In my previous IVF cycle, I did not have embryos in Chennai. I was here and Dr and team had told me not to worry. I was given end to end transparency about my embryos and I was lucky to become pregnant in the 1st cycle here, though I was told that the success rate will be about 25 to 30%.

IVF space is competitive, but these guys don't do any Ads on Google. And still if you search, Dr Jay is ranked no.1. I was extremely impressed with that and I am happy that I took a call to travel to Mumbai from Chennai.

I am thankful to the entire team for handling my case nicely. And May God shower the team with his choicest blessings.

Forum Shah

I visited 3 years back for my IVF treatment at that time and also got good treatment with Dr. Jay Mehta … the best part is he would tell me straight away whatever the cause and outcome would be.

This time also I came for Endometriosis treatment n within 3-4 days decided to get operated as there was no looking back as I trust him for his treatment. Thank you Dr once again for the right advice 😊

Deepak Jagadale

Dr Jay Mehta and team are simply excellent people and brilliant outcomes in Fertility services. Very very honest and humble doctor.

Thank you for the valuable guidance during the IVF process and the excellent and no hidden costs during IVF procedure. For middle class people it's a big relief.

Avinash Jain

Dr. Jay Mehta is a result-oriented specialist in his field and the best we could ask for, in a Metro city. His line of treatment for IVF is different from other IVF clinics.

The support provided by doctors and staff as well as all other attending doctors is phenomenal. We are very satisfied and will also highly recommend to others the IVF treatment at Shree IVF Clinic Mumbai.

Vijaya Garg

Dr. Jay Mehta is one of the best gynaecologist doctor of our India. I trust him faithfully and would like to recommend each and every one that don't waste time moving here and there to another doctorand .

I m sharing my experience I wasted my time mand oney by moving from one doctor to other and my problem was unsolved I'm thankful to Dr. Priyanka Shukla mam of trident hospital for suggesting Dr. Jay Mehta sir for my treatment . Now I'm pain-free...Thank you Dr. Jay Mehta sir... you are really my Boley baba shiv shsmbu. I m thankful to all the staff members of Shree IVF hospital

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