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About Edward Joseph Ramirez, MD, FACOG
Expertise
I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience
I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

You are here: Experts > Health/Fitness > Women's Health > Infertility/Fertility > Dermoid Cyst

Infertility/Fertility - Dermoid Cyst

Expert: Edward Joseph Ramirez, MD, FACOG - 10/30/2009

Question
I'm writing from Fallon Nevada

I went in for an appointment with my MD a few weeks ago after trying to conceive for 1 year. While I was there he did a pap and routine exam as well. In the exam he found my uterus was small or off to the side a bit and wanted me to have an ultra-sound done. When we did this they found a grapfruit-sized dermoid cyst in my left ovary. We're planning on having it surgically removed but I have a few questions. 1. With the size of the cyst is there any chance of keeping a portion of my ovary? 2. If it MUST be removed, is there any possibility of saving my eggs? 3. With a cyst of this size is it wise to do the procedure laparoscopically or should it be done with one large incision? I have no issue with work and recovery time, I just want it done in the safest way to keep my ovary if possible. I do have another appointment with my MD to discuss this information, just looking for some suggestions or input.

Thank you.

Answer
Hello Ky from the U.S.,

A skilled gynecologist will usually remove the Dermoid cyst without sacrificing the ovary. Make sure that your's will do that. The procedure is called a cystectomy. There is no reason the ovary should be removed.

The technology for preserving eggs certainly exists, although the pregnancy rates are not as good. However, we do recommend this in women that have cancer since they would otherwise lose the option of getting pregnant with their own eggs. This will have to be done in an IVF center, and must be done BEFORE the surgery, not during or after. The ovary has to be stimulated to grow the eggs so that they can be removed and frozen.

This procedure should also be done by a method called laparoscopy, using a scope and small incisions. I do this procedure all the time. If your doc can't do it laparoscopically, then find one that can. This is the best method to preserve your ovary and cause minimal damage so that your fertility is not compromised. Try not to have an open (laparotomy) procedure if you can.

I hope this helps,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf

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