I really, really understand your frustration, your pain and your fear! I also know that it is sometimes really hard to make desicions that are BEST for us in the long run when we are under this amount of pressure in all directions. I can tell you what I know from experience and offer my advice...only you can do with it what you will... You probably know by know that a complex cyst can be Blood, endometriosis, or bones and teeth...It is most likely NOT, please hear that, NOT, cancer!!!! Even with an elevated ca-125 reading. Women with endometriosis live with elevated readings and endometriosis does not turn into cancer. That cyst is not "on" your ovary it is IN your ovary...that is why it hurts. Your ovary is only 2-3 cm's big to begin with so anytime a cyst grows beyond that natural size of of ovary it HURTS! It may ache all the time and then pinch or stab when you move a certain way. The "CYST" needs to be removed!!! It Truly is the ONLY way to end this problem!!! This may or "may not" mean that you have to loose an ovary... See that part all depends on the "skill" of the surgeon. Do you get what I mean by that? This surgery is done by laperoscopy...which is a simple surgery. In through the belly button, minimal scar. But they also need to insert a small scapel inside your ovary, opening it, to remove the cyst. This CAN be done without damage to the ovary!!!! BUT it is MUCH easier for a doctor to just snip off the ovary and be done with it. This is where YOU must make some choices and perhaps do some shopping around for a more qualified "surgeon". Your doctor might be great, but if s/he is not in the operating room every day doing this type of surgery...forgetaboutit!!! There are doctors who specialize in female surgery. Knowing how to do a laperoscopy does not make you "good" at it. I know "how" to sew, that does not make me a coture designer. The pill can help, but...if it didn't help you by now it probably won't. It is not a sure thing. Herbs don't always work either, some can make it worse, some can react to the pill. I know the thought of surgery may sound scary but it is honestly the only way to be sure this problem is over. There may be more going on in there than what the doctor can see on tests. There are some problems,like endometriosis, that do NOT show up on any test. It MUST be seen with the naked eye during a laperoscopy. As far as having children... Weighing the odds of this happening again is all you can do. IF you do remove the ovary you can still get pregnant with one ovary! The other ovary will do double time. You also have the option of freezing your eggs from the ovary while it's being removed. There are so many high tech things they can do today... BUT I really feel that the best, safest option and the one that will help you sleep better would be finding a surgeon who can remove it without taking your ovary. You've waited this long... IF that cysts ruptures, which would be around 6-8 cms (sometimes bigger) it would hurt more than anything you have felt before. The contents are things your body has NOT been able to absord... If it is blood/endometriosis you are looking at a superglue type reaction. This happened to me. You do NOT want this to happen!!! Your bowels will be involved...a bowel resection is very painful and takes a very long time to recover from. If it is teeth/hair/bone... those things will be spilled into your pelvic cavtiy and will cause many problems. They could puncture other organs, cause serious bleeding, septic shock, or worse... I know it may seem hard to believe but the cyst is protecting you from the contents...that is why it must be removed. I hope this makes sense... I really hope you are able to figure out what you need to do so that you can feel better!!! Good Luck!