In Reply—Eggermont and colleagues propose the use of ultrasound-guided percutaneous aspiration of ovarian cysts in the neonatal period. The striking variety of location, size, and components prevents a universal therapeutic approach to the treatment of ovarian cysts. A conservative approach with sonographic reevaluation in uncomplicated cysts less than 5 cm in diameter seems indicated in the neonatal period in view of the natural tendency of these cysts to resolve spontaneously.1 Misdiagnosis, however, is possible; cystadenomas and cystic granulosa cell tumors may mimic simple ovarian cysts.2 Large cysts (10 to 12 cm) are more likely to undergo torsion or to rupture; hence, immediate operative intervention is preferred. Puncture of large ovarian follicular cysts guided by laparoscopy has been successfully performed.3
Reappearance of the cyst, however, may ensue. Transabdominal puncture of ovarian cysts shares some of the drawbacks of conservative management (ie, misdiagnosis, recurrence). For large cysts, percutaneous aspiration is