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As a gynecologic surgeon, one of the best parts of my job is getting this joyful email from patients who’d had reproductive concerns: “We’re pregnant!”
So, when Shayna Frost, a Diabetes Educator at the MedStar Diabetes Institute and my patient, shared that she was expecting, we were touched and humbled. She had visited us just two months prior, and we had removed a very large dermoid cyst from her right ovary.
Also called mature teratomas, dermoid cysts are present at birth in approximately 10% of women. These cysts are most common in women ages 20-40. While 98-99% of dermoid cysts are benign (non-cancerous), the growths can make it difficult to become pregnant.
Dermoid cysts can grow to 10cm around or bigger, which is large enough to disrupt ovulation—the release of eggs from the ovary. Though Shayna’s cyst was large enough to press against her uterus, she had no symptoms other than irregular periods.
Dermoid cysts arise from germ cell tissue, which is the starter material for skin, fat, hair, muscle, bone, or thyroid tissue. While most are filled with fat, it’s not uncommon that dermoid cysts contain bits of teeth or hair. However, a dermoid is not an egg, and it could never have developed into a baby.
When Shayna visited our office, she was concerned that she might lose her ovary. But in our minimally invasive gynecologic surgery program at MedStar Health, more than 99% of patients with large ovarian cysts keep their ovary and experience excellent healing.
For Shayna and her husband, making the choice to seek subspecialty gynecologic care paved the way to achieve their dream—becoming parents to a precious baby boy just two days before Mother’s Day 2021.
A perfect Mother’s Day, two years in the making.
I spent my first Mother’s Day snuggling my 2-day old son, Ryan. I wouldn’t have gotten to feel that joy without the compassionate care I got from Dr. Morozov.
My husband and I had been trying to get pregnant since the summer of 2019, and we weren’t having any luck. By February 2020, my periods had become very irregular, and I felt depressed and defeated. Well-meaning friends told me to relax, that I was probably stressed out and I would get pregnant when the time was right. But I know my body and I knew that something was wrong.
In March 2020, the COVID-19 pandemic hit the U.S. in full force, and the stress of it all made us feel even worse about our situation. So, in April 2020, we decided to visit a local fertility clinic for help. Unfortunately, I had to go to all the appointments alone due to pandemic protocols.
I got all the typical workups—lab testing, physical exam, ultrasound—at the fertility clinic. After reviewing my results, the fertility doctor dropped a bombshell on me: “There is a mass that looks like a tumor in your ovary.”
I was floored. The mass, they said, was in my right ovary, and I hadn’t felt so much as an ache or pain. Sitting alone on the exam table, my thoughts began to race. How could I have an ovarian mass? Was it cancer?
Then it hit me like a ton of bricks: I might never be able to get pregnant. Before I fell apart, the fertility doctor suggested I see a gynecologic surgeon who could examine the mass and remove it. Rattled, I left the clinic with a referral card for Vadim Morozov, MD, at MedStar Health.
Though I didn’t know it at the time, Dr. Morozov and his team would restore my hope and set me on the path toward holding Ryan in my arms less than a year later.
Shayna’s first #MothersDay couldn’t have been sweeter. Her son was born 1 year after she was diagnosed with a dermoid #OvarianCyst. See how specialized #gynsurgery with Dr. Vadim Morozov helped make her #pregnancy possible: https://bit.ly/3CKowNa.
My visit with Dr. Morozov.
The minimally invasive gynecologic surgery team put me at ease immediately. Dr. Morozov listened to me with empathy, answering all my questions about COVID-19 safety protocols and whether surgery would be better for me than continuing to try to hope my functioning ovary would pick up the slack.
Left alone, Dr. Morozov explained, dermoid cysts will continue to grow, albeit slowly, and the option to save the affected ovary later would be much slimmer. Also, the dermoid cyst could cause ovarian torsion—a condition in which the ovary twists unnaturally, making simple movements like standing up excruciatingly painful. Ovarian torsion requires emergency surgery, and I’d almost certainly lose my ovary.
However, Dr. Morozov reassured me that if I chose to have laparoscopic cystectomy surgery, the risk of losing my ovary was less than 1%. Though this procedure is complex, it involves just a few steps:
- I’d be placed under general anesthesia, and he would make a few small incisions near my belly button.
- Then, he would inflate my abdomen with carbon dioxide gas to pull my abdominal muscles away from my ovaries for a better line of sight.
- Through the small openings in my abdomen, he would insert tiny surgical tools under visual guidance and make an incision on my ovary.
- Then, he would open the ovary, “like a clamshell,” he said, peeling away the healthy tissue to expose the cyst.
- He would then surround the cyst in a special surgical bag and remove it carefully to avoid spilling any of its contents into my abdomen.
- Finally, he would close up the ovary, allowing it to heal naturally over the next few weeks.
Dr. Morozov said that the ovaries have a remarkable ability to heal after laparoscopic cystectomy, and most women have excellent outcomes. To me, the risks of leaving the cyst alone and potentially being unable to get pregnant weighed heavier than having surgery. My procedure was scheduled in early June 2020, just two weeks after my first visit with Dr. Morozov.
Preparing for the big day.
The whole team at MedStar Health made me feel very prepared and comfortable leading up to the surgery. They’d given me a surgical package that contained pain medication, an anti-nausea patch to wear during surgery, and a special soap to sterilize my abdomen for the procedure.
The package also included directions to MedStar Health at Lafayette Centre, as well as parking information and the cell phone numbers of my core care team. Those extra touches made me feel calm and cared for on what could have been a very stressful day.
Right before the procedure, Dr. Morozov stepped into my room and kindly asked, “Are you ready to go?” I was more than ready—I was eager for the opportunities and excitement that laid ahead.
Recovery, and a big surprise.
After surgery, my diet consisted mainly of liquids and soft foods for the first few days because I was a little queasy. But it only took about three days before I started to feel like myself again. I was restricted from sexual activity and lifting anything over 10 pounds for eight weeks—just in time to get ready to move an hour away.
In August 2020, with the pandemic in full swing, we started packing up our home. I was supposed to go back to the fertility clinic that month to follow-up on another hormonal issue they thought I might have. With everything going on, I decided to postpone the appointment until we were settled in our new community.
As I was packing in the bathroom, I found a pregnancy test kit in the vanity drawer—something that never would have happened in 2019 when I was frantically taking tests every time I missed a period. I decided to take the test and braced myself for disappointment.
Instead, I saw tiny lines forming in the viewer window. The test was positive. It was unbelievable—the happiest day of my life up to that point! Once my Ob/Gyn confirmed the pregnancy, I sent Dr. Morozov a note. He was thrilled for us and eager for updates.
Difficult journey, beautiful ending.
Ryan was born May 7, 2021, almost a year from the day I found out about the dermoid cyst. Now, he’s almost three months old and starting to babble—what a difference a year can make!
Raising a baby takes a village, and I am so glad Dr. Morozov was in ours from the start. The journey to become pregnant was difficult, but it was so worth it. I felt extremely cared for, and my sweet baby brings me so much joy.
Please go see Dr. Morozov if you develop an ovarian cyst. He is an expert in fertility-sparing cyst removal, and he will help you understand all your options before you make the choice to have surgery.
Expert gynecologic surgery at MedStar Health.
Stories like Shayna’s remind me of why I became a gynecologic surgeon—to help patients live life to the fullest. Our team works hard to make sure every patient feels supported, reassured, and confident in making healthcare decisions.
Though many women’s health providers may recommend removing the entire ovary (oophorectomy) to treat a large cyst, that is rarely the case at MedStar Health. Our gynecologic surgeons are fellowship-trained in the most delicate and complex surgeries. In more than 99% of patients, we can remove the cyst, sparing the ovary and preserving fertility.
MedStar Health is one of the country’s leading training sites for minimally invasive gynecologic surgery. We are pioneers in the latest techniques and technology. Our team is equipped with the energy and expertise to manage the most challenging and unique gynecologic conditions, and we are eager to support you in making your dreams a reality.
Even in complex cases, there is rarely just one treatment option. If you are uncomfortable with the solution a doctor suggests, seek a second opinion. Getting more information takes a little extra time, but it will be time well spent if you can avoid an unnecessarily invasive or permanent procedure.