Clinical management of functional ovarian cysts: a prospective and randomized study

Most ovarian cysts in women of reproductive age are physiological (function al) and patients have been treated for years with oral contraceptives to ob tain the resolution of these cysts, Expectant management has been suggested to have the same effectiveness as hormonal treatment but such suggestions come from studies including all kinds of cysts. The objective of the presen t study was to assess the resolution of functional ovarian cysts, observed after ovulation induction, with expectant management and hormonal treatment and also to determine the period of time necessary for the resolution of t he cysts. For this purpose, 53 patients with ovarian cysts, observed by tra nsvaginal ultrasound within the first 5 days of a cycle after ovulation ind uction, mere randomized to have expectant management (group A) or to receiv e oral contraception (group B) for one cycle, If the cyst persisted, the pa tient was followed for another cycle, without any treatment. Within the 50 women who completed the trial, a complete resolution of the cysts was obser ved in 19/25 (76%) and 18/25 (72%) in groups A and B respectively. On the o ther hand, all the persistent cysts disappeared after a second cycle withou t any treatment. In conclusion, expectant management is as effective as ora l contraceptives for the resolution of functional ovarian cysts induced by ovarian stimulation. However, studies with a larger number of cases are nee ded to increase the power of the results and to obtain a firm conclusion.