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Mr. and Mrs. X,24 yrs. visited our clinic with Primary Infertility of 1 year and severe dysmenorrhoea.
 
Primary infertility is defined as a condition in which a couple is unable to conceive naturally even after having unprotected intercourse for over a year.
 
Dysmenorrhoea is a term used to describe painful periods.
 
A thorough medical evaluation including sonography revealed that she had Bilateral chocolate cysts with severely decreased ovarian reserve in Right ovary and left ovary having no follicles.
 
Chocolate cysts or endometrioma are cysts containing old blood. They develop inside ovaries and can affect ovarian function. In some cases, chocolate cysts can stop the ovaries from working and so prevent pregnancy.
 
These cysts can be difficult to treat, and the pelvic surgeries used to remove them can lead to ovarian scarring and reduced fertility. Removal of these cysts always involves damage to remaining ovarian tissue also. Hence, surgery requires utmost care and expertise and needs to be performed by a trained laparoscopic surgeon to conserve as much healthy ovarian tissue as possible to improve the chances of pregnancy in these patients.
 
Treatment planned
 
She was advised Laparoscopy. During laparoscopy, bilateral chocolate cysts were removed taking utmost care. She came after 4 months with natural conception.

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