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The chocolate cyst is one of the most common gynecological problems that prevent conception all over the world. The factors affecting the formation of the chocolate cyst are not yet known for certain. There are several theories of the occurrence of the disease. It is the most accepted theory that the tissue in the uterus is transported to the abdomen with the help of the fallopian tubes.

Who does it occur in?

The chocolate cyst, which is common among the 25-34 age group, affects about 10 of women. Women who have a chocolate cyst near the first degree are at greater risk than other women. Genetic predisposition is important in the development and occurrence of the disease.

In some types of chocolate cysts, there may be situations where surgical intervention is required due to the tendency to cancer and growth. In such surgical interventions, egg collection and freezing are recommended against possible ovarian damage after surgery.

Does it interfere with conception?

17% of women who cannot have children have a chocolate cyst. Due to the fact that it causes inflammation in the abdominal cavity, leads to adhesions in the tubes and ovaries, it disrupts the suitability of the inner wall of the uterus for pregnancy and leads to a decrease in ovarian reserve, thereby leading to infertility. Women who have chocolate cysts in both ovaries should not postpone their desire to have children.

What are the symptoms?

The chocolate cyst, which has many symptoms, most often makes itself felt with increasing pain during menstruation. It begins a few days before menstruation and continues throughout the menstrual period, and with the onset of bleeding, the pain increases sharply.

Other symptoms of chocolate cyst that also causes pain during sexual intercourse can be listed as follows; bloody stools, bleeding and blood in the anus, frequent urination and burning in the urine, back and back pain, nasal bleeding or bruising during menstruation, pain that hits the legs, abdominal pain, constipation and diarrhea, pain that hits the anus.

How is it treated?

Early detection is very important to prevent disease-related problems. For the treatment of the disease, it is necessary to separate the ovary from other cysts by conducting a gynecological examination and an ultrasonographic examination. We recommend that our patients who have a chocolate cyst and want to become pregnant do not postpone their desire to have children.

Especially infertile women over the age of 35 are advised to start IVF treatment because the risk of ovarian reserve reduction increases even more. The chances of IVF success in women who cannot have children due to this disease vary depending on the patient’s age, partner’s sperm status, and ovarian reserve.

Turkish Obstetrics and Gynecology Specialist Op. Doctor…


What is endometriosis?

Endometriosis is a condition in which the type of tissue that makes up the inside of the uterus (endometrium) is located outside the uterus.

How common is endometriosis?

Endometriosis occurs in 1 out of every 10 women of reproductive age. It is most often diagnosed in women in their 30s and 40s.

Where does endometriosis occur?

Areas of endometrial tissue (often called implants) are most often formed in the following places:

– Abdominal membrane

– Ovaries (Chocolate cyst)

– Fallopian tubes

– Uterus, urinary bladder, urinary ducts, intestines

– Douglas cavity (the cavity behind the uterus)

How does endometriosis cause problems?

Endometriosis tissue responds to changes in a hormone called estrogen. The tissue can grow and bleed during the menstrual cycle, as well as the internal tissue of the uterus. The surrounding tissue may become irritated, inflamed and swollen. The breakdown and bleeding of this tissue every month can also cause scar tissue to form. This scar tissue is called adhesions. Sometimes adhesions can cause organs to stick together. Bleeding, inflammation and scarring can cause pain, especially before and during menstruation.

What are the symptoms of endometriosis?

The most common symptom of endometriosis is chronic (prolonged) pelvic pain, especially immediately before and during menstruation. Pain can also occur during sexual intercourse. If endometriosis affects the intestine, there may be pain during bowel movements. If it affects the bladder, there may be pain during urination. Heavy menstruation is another symptom of endometriosis. Many women with endometriosis have no symptoms at all. Women who do not have symptoms often find out that they have endometriosis when they cannot get pregnant or have surgery for something else.

What is the between infertility and endometriosis?

About 4 out of every 10 women with infertility have endometriosis. Inflammation caused by endometriosis can damage the sperm or egg or interfere with their movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes can be blocked by adhesions or scar tissue.

How is endometriosis diagnosed?

An obstetrician-gynecologist can first do a physical examination, including a pelvic examination. But the only way to be sure that it is endometriosis is through a surgical procedure called laparoscopy. Sometimes a small amount of tissue is taken during the procedure and tested in the laboratory. This is called a biopsy.

How is endometriosis treated?

Treatment of endometriosis depends on the size of the disease-its severity, your symptoms and whether you want to have children. Endometriosis can be treated with medication, surgery, or both. When pain is the primary problem, medication is usually tried first.

What drugs are used to treat endometriosis?

Medications used to treat endometriosis include painkillers and birth control pills, such as nonsteroidal anti-inflammatory drugs (NSAIDs), progestin-only drugs, and hormonal drugs such as gonadotropin releasing hormone (GnRH) agonists. Hormonal drugs help slow down the growth of endometrial tissue and can prevent the formation of new adhesions. These drugs are typically not able to clear the already existing endometriosis tissue.

How can surgery treat endometriosis?

Surgery helps to remove endometriosis tissue. Removal of this tissue can relieve pain and improve fertility.

Does surgery cure endometriosis?

Most women recover from pain after surgery. But there is a possibility that the pain will come back. 8 out of 10 women experience pain again within 2 years after surgery. The reason for this may be foci of endometriosis that do not appear or can not be removed during surgery. The more severe the disease, the more likely it is to return. Taking birth control pills or other medications after surgery can help prolong the painless period.

What if I have severe pain that does not go away even after treatment?

If the pain is severe and does not pass after treatment, removal of the uterus may be a “last resort” option. If your ovaries are removed during a hysterectomy, endometriosis is less likely to cause pain in the future. The purpose of surgical treatment in both cases is to remove endometriosis located outside the uterus as much as possible.

Turkish Prof. Dr. Obstetrician and Gynecologist…


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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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