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A 24-year-old woman presents to the emergency department concerned that she cannot find the threads for her intra-uterine device and cannot get an appointment at her GP. She denies any pain, pyrexia, or atypical discharge. She has a regular 28-day menstrual cycle, and her last menstrual period was 7 days ago. She has a transvaginal ultrasound as the threads are not visualised on speculum examination. The device is visualised and threads are found to be drawn back into the cervical canal. The threads are brought back into view. There is also noted to be a 4cm multiloculated cyst with strong blood flow in the right ovary. What is the most appropriate action?a) reassure patient as cyst is asymptomaticb) refer for biopsy of cystc) refer for urgent laparotomy and cyst removald) yearly transvaginal ultrasound to assess for cyst growth or changese) reassure patient as cyst is < 5cm

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