# Have you ever passed a corpus luteum cyst? *Update: Lab Report post #18*



## momileigh

I think I may have passed two corpus luteum cysts, one a few months ago and one last night. I'm sending what I passed to a lab, but meanwhile I'd be interested to know if anyone has any experience with this. Also, I consider myself pretty handy with google, but I couldn't find much, so links to any info would be appreciated!

For background on my current situation, see this thread: http://www.mothering.com/discussions....php?p=8912293 (Read posts 1, 3, 6-8 for the story.)

**Update: Lab Report details in post #18.**


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## naturegirl7

passed?
That confuses me - I had 2 corpus luteal cysts when pregnant - large enough and painful enough to send me to my MW and have then do an ultrasound cuz they thought I was maybe having an ectoptic pregnancy. Turns out it was 2 corpus luteal cysts on my ovaries. I am prone to ovarian cysts related to ovulation.

I was told that the corpus luteal cyst forms in every woman when fertilization occurs and that it disolves after the placenta starts producing the necessary hormones to support pregnancy - until the placenta is functioning and producing these hormones, the cl cyst does that.

I was told that my cysts were just slightly larger and not disolving as fast, and that it was not a surprise due to my history with ovarian cysts. I was told that they were not large enough to warrant any intervention (thank goodness!) and that I would just have to deal with them until they finally disolved. Which is exactly what I did. At the 21 wk US, they checked again and they were gone. I'd say they were gone a few weeks at that point cuz I did't have any pain anymore, could bend and twist and enjoy sex again.

I have had several ovarian cysts rupture, but never "passed" anything - just had some discharge and lots of pain....

as for the other thread - I was on the pill for years, took a break due to needing knee surgery and the increased risk of clots. I went back on the same pill - I had what both my MW and I felt was a miscarriage (I got really crampy, spotted mid cycle, passed what I can only call a small mass of tissue, and then bled horribly). I went in for the blood test, to determine if I was pregnant and to get a baseline so they could recheck it and make sure the miscarriage was complete. It came back negative - I was never even pregnant. Here Dh and I spent the weekend mourning the loss of a baby that never existed.....I was even more upset and angry. When the MW and I talked further about it - it was "just a fluke of being on the pill" - I never took BC again. I started using FAM and just dealing with the horrific PMS, severe hormonal migraines, heavy flow, cramps and nausea that send me to bed, and constant occurence of ovarian cysts.
I do know that you can "safely" take the pill up to 3 months at a time without getting a period. Longer than that is not considered safe and increases risks - cuz the endometrium is not shedding like it is supposed to....and that it is very very common to have breakthru bleeding with the continuous pill until your body is re-programmed - you should expect that breakthru bleeding could last up to a year.
I have heard that you should not take the pill for more than 5 years straight, then need to take a break for like a year or so and then go back on them.....but that doesn't seem to apply to you. The pill you were on before - were you trying it out or was it a trial drug?? If it was a trial - Could it have affected your fertility and/or reproductive organs?
Glad you saved the tissue and are testing it. keep us updated!


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## momileigh

Michelle... it wasn't a "trial" drug, I was just trying it out for myself! Both brands were just run-of-the-mill monophasic oc's like have always worked beautifully for me before.

Your "miscarriage" sounds a lot like what I've had! Maybe I will help solve your "fluke" of being on the pill. (If you had to describe what you passed further, could you?)

IF what I passed was a corpus luteum cyst, I think it is very, very strange that I had absolutely no pain whatsoever associated with it until I passed it. (When I say passed, I hope you understand, I mean it came out of my vagina, after 10 days of moderate, painless bleeding and about 5 hours of killer cramps.) I mean, wouldn't something golf-ball sized traveling through your fallopian tube just KILL? I felt nothing.

If it wasn't a cyst, I wonder if it was a blighted ovum. If so, would it have happened whether I was on the pill or not?

Let me tell you, it is very unsettling having something come out of my body that my "I've seen it all" midwife can't identify. I sent it to pathology today and will update when I know more.


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## MCatLvrMom2A&X

Corpus luetum cysts are on the ovaries there is no way one could pass thru the tiny fallopian tube. They are what makes progesterone during the lp. I dont know what you passed but it couldnt have been a Corpus luetum cyst unless something is very wrong with your anatomy.

I hope that dosnt sound snarky







I honestly didnt mean for it to. I hope you find out exactly what you passed.


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## momileigh

I know that corpus luteum cysts are usually on the ovary, that they are normal, that you need one to support a pregnancy for the first trimester, and that they can grow abnormally large and cause pain and eventually rupture and the pain stops.

I agree that it seems impossible for it to detach and travel through the fallopian tube. However, I found this paragraph on a pregnancy loss website:

"But I got this huge golf-ball sized clot I've never seen before. It had to be a baby."
"Tissue that is like a ball is often what is called a corpus luteum cyst, and not a baby. An extra long or extra short period can be caused when the shell that once housed the egg (called the corpus luteum) swells in size and throws off the hormone chain. This ball will come out in the period, leaving many women to believe they were pregnant, when actually they had a non-viable egg that month."

I have emailed the author of that article to ask for resources and clarification.

I don't *think* there could be something seriously wrong with my anatomy with my totally normal (actually above average until now) gynecological, sexual, and reproductive history. But then again, I'm passing what look like alien life forms, so who knows?

Don't worry, I didn't read any snark.  Thanks for the input.


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## MCatLvrMom2A&X

Quote:

An extra long or extra short period can be caused when the shell that once housed the egg (called the corpus luteum) swells in size and throws off the hormone chain.
I think this article is talking about the egg shell itself not the corpus luteum cyst that is on the ovary.

The outer layer of the egg is not exactly solid but it is firm and it protects the egg as it devides in the tubes so that it cant attach there that part is called the corpus luteum. When the egg reaches the uterus in a normal pg. It releases the growing cells inside. Like a snake shedding its skin.

When there is no viable pg or blighted ovum the shell would probably not break open leave behind a large ball of cells that would be passed.
I hope that made sense.


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## momileigh

Melissa - I'm actually not sure what you're saying here. The article seems pretty clear that the corpus luteum cyst is what is being passed. (Not that I'm vouching for the article... I don't know yet.) Are you saying you think the "thing" is probably a blighted ovum? Because I also can't find any references to a blighted ovum being passed as a golf-ball sized bubble of tissue. But that is my next best guess as to what it is.


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## naturegirl7

I understand what you mean by passed - just not in reference to the cyst itself. I don't understand how physically a cyst could just detach from the ovary and pass thru the fallopian tube and the uterus. That doens't make much sense to me. I mean, a cyst is generally fluid filled - so it can rupture, but not "detach" to pass thru the rest of the system. I can't see how it could detach without rupturing....I can't imagine that something the size of a golfball could pass into and thru the fallopian tube. or that it would be possible to have a golfball sized cyst on your ovary and NOT feel it before you "pass" it. Ovarian cysts are painful. Mine were nowhere even close to that size - but I had trouble sitting, bending, walking, laying on that side, having sex, the list goes on and on. It hurts.

also, if you are on the pill - you should not be ovulating, so there should be no cyst. let alone two of them....

as for what I experienced. It was tissue - NOT a clot (trust me I know them all too well!). it was this mass of tissue, bean shaped not really round, and about the size of a half dollar, there was a bloody tail to it that looked kinda like a "vein" that connected to its center - honestly it reminded me very much of the pics of early embryos and the beginnings of the placenta.

My MW felt that it was "most likely" endometrial tissue that just came off in a chunk - hence the cramping, severe pain, and nasty bleeding afterwards....

I'd love to know what yours is - before now I have never heard of anyone else having anything remotely close to what I experienced.


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## momileigh

Michelle: I agree with all that about the cyst not making sense... but the description from that online article (a golf-ball sized ball of tissue that comes out and leads women to believe they were pregnant) is pretty much spot-on, and I haven't found any other alternatives (besides blighted ovum) that make any sense. Plus, what I passed looked like pictures of actual cysts that I found on google images.

Mine wasn't a clot either. It felt like a clot when it came out, but when I looked at it, it was pale in color, and when I touched it, it had a definate, bubble-like form. It was tissue. And it had a "bloody tail" and some of the other characteristics you describe yours having! I really think we're talking about the same thing!

And absolutely I shouldn't have ovulated on the pill, so cyst or blighted ovum (which is a product of conception) should not have happened. But regardless something did happen that shouldn't have happened on the pill, and I think "chunk of endometrial tissue" is a throwaway explanation from a midwife who couldn't identify something. (Not an insult... this is sufficiently rare, I think, that any midwife can be forgiven for not knowing what it is, including all of mine.) Women shed their endometrial linings right and left all the time, and you never hear of this happening, right? And this thing had too much form, was too intact... it was something that grew somewhere.

I seriously can't wait to get the lab results. Waiting is going to drive me crazy!


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## naturegirl7

now you have me googling stuff too!









my MW felt that it was most likley endometrial tissue - with my history of severe cramping, heavy bleeding, nasty periods and my mother having endometriosis.... that maybe I had some thickening of the endometrium while off the pill and this was some of the extra tissue being removed...
but admitted that she never saw anything like it, but that the pill often causes breakthru bleeding after taking a break and going back on it. And just chalked it up to a "fluke of the pill"

check out this pic - it is similiar to the other one you posted - this is more "ball" shaped that the C.L. cyst, and could explain the cramps and heavy bleeding....it is an endometriosis cyst - as the endometriosis creeps onto the ovary, it is filled with blood not fluid, so maybe that would explain the heavy bleeding?? And due to it being endometrial tissue, it would be more tissue like in appearance? and it has a red spot, like the veiny thing I was trying to describe...

How long before you get the report back on it????









http://home.cfl.rr.com/dahmd/endocyst.htm


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## momileigh

I have no idea. It is isn't the kind of test we usually order, so I don't know how long it takes the lab. My guess is one week.

btw, the pic I posted was of an ovary, not a corpus luteum cyst. But that ovary is such a dead ringer for what I passed, it freaked me out, thinking I could have passed my ovaries! (I realize they are hooked in there pretty good and it was an irrational thought, but a lot of weird things can go through your head when you have become a strange new case study.)


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## supakitty

I bet it was a benign uterine polyp or possibly a degenerated uterine fibroid.


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## momileigh

supakitty-- do you have any information that indicates that uterine polyps or fibroids can be passed out of the body? Everything I looked up indicated they had to be removed surgically. (The same is often said for blighted ovum.)


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## supakitty

I have personally removed them from a woman's cervical os when they are in the process of passing and I have also seen the ones that women will bring in to the office when they have passed it at home. The ones that I have removed I have sent to pathology and they have always been benign uterine polyps.


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## momileigh

Oooh, can I ask you some more questions? And did you read my other thread?

What is your profession?

What do the passed polyps usually look like?

Wouldn't it seem strange that a polyp would develop and grow while on oral contraceptives?

As much info as you can share, I'd love to hear.


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## heatherh

Well this is all very fascinating. I'll try to sum all this up in a way that makes sense







Leigh, I also passed something that looks an awful lot like your photo of an ovary. But without the red/orange cysts. It was whitish and fleshy and approx golf ball size (but a little squished - not as round).

The thing is, it was a few cycles after a miscarriage that was likely (although not officially diagnosed as such) a blighted ovum. And I'm 99% sure I passed the sac and pieces of placenta (way prior to this) - so I'm almost *positive* that the whitish fleshy thing was NOT a blighted ovum. This whitish thing was not all vascular like the placenta pieces, and it wasn't a sac and didn't have anything inside it - just a chunk of fleshy material. I had several hours of horrible cramping and then it just appeared with a plop. I know I ovulated prior to passing the fleshy material and it passed during my period.

Also, when I had the ultrasound that diagnosed the impending miscarriage, doc (very experienced w/ ultrasounds - like 22+ years) said my ovaries looked good and did not note anything particularly unusual about the situation. I think that would most likely rule out any uterine growths.

We're actually TTC and I'm (duh) not on the pill. I just kind of assumed this was somehow miscarriage related, but I wasn't able to find pictures even close to what I saw. It's really hard to search for.

So I'm really curious to find out what it was that you passed.


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## momileigh

Hi heather, welcome to our new little club! I *really hope* the lab results come back tomorrow and will update right away. Your story sounds very much like mine and Michelle's to me, except for the fact that you are not on any birth control. And it sounds very much like what that article talks about. (No word from the author of that article yet, btw.) If I hadn't really played with "the object," I wouldn't have known it was bubble-like, it would have just seemed like a squashy ball of tissue. But as I manipulated it, I was able to put my finger in a hole on one side and wear it like a giant thimble.

So, since you were so in tune with your cycle, it seems you are more or less convinced that whatever this was developed over the course of one menstrual cycle, correct? You had a normal period, you ovulated, and then during the following (otherwise normal) period you passed this? Do I have that right?

Anyway, good luck with the ttc and stay tuned for lab results!


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## momileigh

Lab Report!

Gross Description: Specimen is received in a non-fixative solution and consists of a portion of pink-tan, focally hemorrhagic tissue measuring 4.5 x 4.0 x up to 1.2 cm.

Diagnosis: Benign mixed phase endometrium with extensive stromal decidual change and areas of necrosis and hemorrhage consistent with active bleeding; no hyperplasia or malignancy identified.

So, in layman's terms.... ??????????????????????

My mw couldn't explain it to me. We've faxed it to an OB/Gyn friend of hers, who will hopefully get back to us on it. And I left a message for the doctor who did the report, and I hope he will call me back soon.

As far as I can tell:

1. Not a product of conception (blighted ovum/miscarriage)
2. Not a cyst
3. "chunk of endometrial tissue" may be the closest guess anyone had after all
4. Not an ovary or anything else particularly scary
5. Not a polyp or fibroid

Questions I still have:

1. What?!?!?
2. Why did this happen?
3. How is this related to me being on the pill?
4. How can I prevent this from happening in the future?


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## heatherh

I guess I should clarify some things









I did not notice any holes or indentations to speak of - but if they're just blobs of tissue, I suppose that variation is reasonable. I actually cut into my "blob" to see if there was anything interesting going on inside and it was... not so revealing. It really just seemed to be tissue with a little blood... not particularly vascular, not muscle-y. No recognizable structures.

So, this thing could have developed over the course of one long cycle. I'm not sure. If you click the link in my siggy, check out the cycle that started on Apr 21st... it was after that cycle that this thing appeared. This long cycle was the first cycle where I ovulated after my miscarriage. The period before was very light - only one day, but the one after was pretty normal - a little heavy - mostly around passing the blob.

In laymen's terms, is the lab report saying that it's a blob of tissue that had started to decompose? And they can somehow tell that it was bleeding at some point?

My theory is that these are somehow related to hormonal changes/adjustments. Maybe the way your body reacts to hormones makes it try to adjust somehow... and my body was still adjusting after the miscarriage? Maybe this somehow produces extra endometrial tissue and/or causes it to form clumps and/or shed? I would think hormonal changes/instability is probably the common thread here. 'Course, it's possible they were around for a long time and hormonal stuff caused them to detach.

Have you tried an IUD?


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## momileigh

I hope I get more concrete answers! Will post when/if I get more info. I do expect a call from the doctor who did the report tomorrow.

I would not *survive* the implantation of an IUD. I don't like having my cervix touched by fingers, much less pinched with atraumatic forceps... ugh!!!!!!!! Nonononono, thanks for the thought.







Plus, I want to achieve menstrual suppression.


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## texaspeach

sounds like it was just a giant hunk of endometrium. when I've passed endometrial tissue, it was sort of.. grayish and it didn't look like a bubble. I'm glad to hear it was benign and not products of conception. at least you've been able to rule a few things out

do you think changing to a different pill formulation would prevent the problem next time? since you're trying to achieve menstrual suppression what about Implanon (etonogestrel implant)? it can cause irregular bleeding but is supposed to make periods very light or go away totally. my dr suggested it for me as I have suspected endometriosis, I don't tolerate hormones well so I haven't tried it. The side effects are similar to depo provera, but it's a different flavor progestin so hopefully it doesn't cause the bone loss issue that depo does.

Thank you for sharing your labs. I hope you get some more concrete answers soon


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## naturegirl7

Sounds like maybe it was endometrial tissue. Thank goodness it was bengin! That makes me feel a bit better. Still anxious to hear what that OB says though.

I googled
Benign mixed phase endometrium with extensive stromal decidual change
and quite a bit actually came up. Lots about endometriosis and polyps....but this is the best link I found - lots of good info.

http://www.ucc.ie/ucc/depts/path/LN/FemaleGTract.doc

Here is some of what this one said (quoted below) - what I get out of it is that there are disctinct hormonal phases whcih result in various changes in the endometrium and its various types of tissues - with edema and a round appearance of the stroma layer/tissue naturally occuring and increasing over the course of your cycle and with the decidual change being normal for the stromal layer approaching/during menses. Other articles also talk about stroma cells aggregating during the different phases, to become large and round - one called them "blue balls" of endometrial tissue.

Sounds like you passed a large mass of stroma endometrial tissue (maybe even a polyp?) - perhaps as a result of the hormonal changes from the pill - maybe the hormones were too much - that they made it grow larger than normal??? There is also a portion that says that during pregnancy, decidous changes are more pronounced - which could be linked back to the pill since it induced a faux early pregnancy state to suppress ovulation.

All I know, it that it sounds like they should not get that big, and should disolve on their own once conception does not occur. So something happened hormonally within our bodies to increase the rate at which it grew. And decomposed enough so that it was shed with the endometrial tissue during menses. I am just glad that my was expelled, rather than sitting around in my uterus!

Hope this info is helpful.









Quote:

Menstrual Cycle.
28 day cycle.
Proliferative Phase. During first 14 days after menstruation (3-5 days) under oestrogenic stimulation, produced by effect of FSH on the ovarian Graafian follicle (granulosa cells) the endometrium exhibits proliferation of both narrow round tubular glands and compact stroma which develops from the outer one-third of the endometrium. Mitoses seen in both glands and stroma. *Oedema develops in stroma*.
Secretory Phase Following ovulation, mediated by pituitary LH and a further surge of FSH, the ovarian graafian follicle is transformed into a Corpus Luteum which continues to secrete oestrogen but also progesterone.
Early Secretory Phase Day 17-20, Endometrial glands enlarge and lining cells develop subnuclear vacuolation (glycogen rich), *Stromal oedema*+. No mitoses.
*Late Secretory Phase Day 21-27. Secretion in lumens of glands which now become enlarged and tortuous. Stromal oedema++. Increased tortuosity of stromal vessels. Stromal cells become enlarged and rounded and is complete by Day 27. Endometrium now prepared for implantation of fertilised ovum. In the absence of pregnancy, stroma is infiltrated by acute inflammatory cells and granular cells. Corpus Luteum in ovary degenerates, progresterone and oestrogen level drops and the luminal two-thirds of the endometrium desintegrates and is cast off (Menstruation) with haemorrhage.*

Pregnancy Following fertilisation and implantation of the ovum in the endometrium (about 4-5 days after ovulation) the Corpus Luteum continues to secrete oestrogen and progesterone with *increased decidualistion of stroma and glandular secretion*. Arias-stella change - marked hypersecretory state of glands.

Combined Oestrogen/Progesterone Little oestrogen stimulation, mainly progesterone effect. *Decidual change* and glandular atrophy. Some side effects mainly with long-term use.

Endometrial Polyps Common in perimenopausal and menopausal endometrium. May be sessile or pedunculated up to about 3 cms. in diameter. *Usually associated with inappropriate reaction of part of the endometrium of oestrogenic stimulation*.

Endometriosis *Endometrial glands and stroma outside of the uterus* e.g. in ovaries, fallopian tubes, pouch of Douglas, mesentery, gastrointestinal tract, skin, scars etc.
Cause Unknown (1) ? Implantation from retrograde menstruation.
(2) Metaplasia of peritoneal serosa.
Regresses following menopause.

otehr links:

http://www.ajsp.com/pt/re/ajsp/abstr...195629!8091!-1

http://www.cap.org/apps/docs/annual_...ium_Part_1.pdf

www.accessmedicine.com/content.aspx?aID=191317
this one looks promising, but you have to register (pay?) to access it


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## momileigh

Hey, thanks for that research. Supakitty, did you think the diagnosis was consistent with a polyp? Because it didn't specifically say that, but I found out today that the OB/Gyn got back to my mw and told her that it sounds like it *was* an "endometrial polyp." She said that I might have tons of them in there and I should have an endometrial biopsy.







That is so not going to happen. She said it may interfere with future fertility if I have a bunch more and don't have them removed.

My gut is telling me that this is nonsense, about having tons of them in there. Both times this has happened, once I've passed the thing I've had a normal period and been normal since. I'm going to go a couple cycles without any hormonal contraceptives and see if all seems normal. If so, I just don't think I could have a bunch of polyps sitting in there. If not... well, I suppose I'd better get some medical insurance


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## naturegirl7

My mom had a bunch of polyps removed this Jan. She had severe pain that got worse during intercourse. And serious bleeding despite having gone thru menopause over a year prior.
She came up to see me for Xmas, which is when I learned of it and learned that her docs would not get her in until April - so I called my MW, who squeezed her in right away. We wanted to make sure it was not cancer.
She had a pelvic, a PAP - all normal. And was sent for a US the next day.
It was diagnosed as polyps via a vaginal US.
When she went back home, got in faster due to the diagnosis and report, and then worked out a treatment plan with her doc - which in her case was surgery. My mom was pushing for a hysterectomy, but thankfully the doc wasn't sold on the idea.

talk to your MW about a vaginal US and see if it is an option for you.

BTW - I have been checking out the House of Babies show - and you are right, that was just a really really horrible episode! The rest have been sooo much better, not completely based upon what I consider midwifery model of care - but way better than that one episode. that episode doesn't even seem to fit in with the rest of them.... I caught part of your birth - what a lovely family you have! I wish they hadn't sucked that thread into the internet abyss. I know it is completely off topic, but I just wanted to let you know I give it a second and third chance.


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