What Is Endometriosis (Chocolate Cyst)?
Istanbul Şişli FertiJin IVF Center
Endometriosis is a disease known medically as a chocolate cyst that affects women’s reproductive health.
It occurs when the endometrium tissue, which lines the inside of the uterus, is also found outside the uterus.
It is seen in approximately 5% of women of reproductive age and has an important place among causes of infertility with a rate of 35–40%.
Endometriosis is most commonly seen in the ovaries, fallopian tubes, and the outer surface of the uterus; rarely, it may also be found in other organs.
These tissues located outside the uterus bleed under the influence of hormones in each menstrual cycle, but since they cannot be expelled from the body, they cause inflammation, adhesions, and pain in surrounding tissues.
What Causes Endometriosis (Chocolate Cyst)?
Although the exact cause of endometriosis is not known, genetic and immune system disorders play an important role.
- The risk of the disease is 7 times higher in women who have a family history of endometriosis.
- As a result of malfunctioning of the immune system, endometrium-like cells outside the uterus cannot be destroyed and begin to grow in these areas.
- The disease may progress over time, leading to adhesions between tissues and cyst formation.
Endometriosis (Chocolate Cyst) Symptoms
Symptoms of endometriosis may vary from person to person. However, the most common finding is pain during menstruation or sexual intercourse.
Common Symptoms:
- Increased severity of menstrual cramps
- Pain during sexual intercourse (dyspareunia)
- Menstrual irregularities, spotting
- Pain in the abdomen and lower back
- Infertility
- Severe fatigue or gastrointestinal problems
➡️ Note: Endometriosis may not always cause pain; therefore, regular gynecological examination is very important for early diagnosis.
Endometriosis (Chocolate Cyst) Treatment
Endometriosis treatment is planned individually. At FertiJin IVF Center, the most appropriate treatment method is determined according to the extent of the disease, age, and desire for pregnancy.
Hormonal Treatment
The growth of endometrium-like tissues is stopped by balancing hormone levels.
- Birth control pills
- Hormonal intrauterine device (IUD)
- Hormone injections and shots
- GnRH analogues
Surgical Treatment
In advanced cases, endometriosis foci are removed with the laparoscopic surgery method.
In some cases, hysterectomy (removal of the uterus) may be required.
Surgical interventions reduce pain and help preserve fertility.
Supportive Treatments
- Physiotherapy and pelvic muscle exercises
- Dietary adjustments (anti-inflammatory nutrition)
- Pain management, heat application, yoga, and breathing exercises
What Helps Endometriosis (Chocolate Cyst) Pain?
Pain management is important to improve quality of life.
- For mild pain, painkillers with doctor approval may be used.
- Heat application (for example, a hot water bottle) relaxes the muscles.
- Yoga, breathing exercises, and light walks may help reduce pain.
If there is severe pain or cramps affecting daily life during menstruation, an evaluation by a gynecologist should be performed without delay.
What Is a Chocolate Cyst?
Endometriosis may cause the formation of dark-colored cysts filled with clotted blood on the ovaries.
These cysts are called “chocolate cysts” (endometrioma).
Over time, the cyst may grow and negatively affect the ovarian reserve. Therefore, early diagnosis is very important.
The Relationship Between Endometriosis and Pregnancy
Endometriosis may make pregnancy difficult by causing adhesions and hormonal imbalances in the pelvic region.
- Blockage of the fallopian tubes,
- Decreased ovarian functions,
- Impaired embryo development may be observed.
Scientific studies show that changes in the peritoneal fluid in women with endometriosis may negatively affect embryo development.
This condition may make IVF treatment necessary.
Endometriosis and Adhesion (Adhesion)
Tissues shed due to endometriosis and blood accumulations may create inflammatory reactions and adhesions in the abdomen.
These adhesions may cause organs such as the uterus, ovaries, and intestines to stick together.
Symptoms are usually pelvic pain, constipation, and infertility.
Adhesion treatment can be performed with laparoscopic surgery.
How Is Endometriosis Diagnosed?
For definitive diagnosis, laparoscopy is the most reliable method.
At FertiJin, the diagnostic process progresses with the following steps:
- Evaluation of the patient’s medical history
- Ultrasonography and examination
- If necessary, laparoscopic imaging
Thanks to laparoscopy, both diagnosis is made and the cleaning of the foci can be performed in the same session.
Endometriosis in IVF Treatment
In patients with endometriosis, IVF treatment after laparoscopy can be applied with high success rates.
- Endometriosis foci are cleaned with surgery.
- If pregnancy does not occur within 6 months, IVF treatment is started.
- When necessary, the foci are reduced with medication before surgery.
With IVF treatment after endometriosis surgery, the pregnancy rate increases significantly.