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Chris, I am glad that you are supporting your wife and doing research about LO-CAH. I have cramps and suffer from ovarian cysts that get large and rupture. Are the cramps located more to the sides of her abdomen? I see that she's had ultrasounds so I assume they haven't found any tumors or endometriosis? Sometimes a doctor won't tell a woman if she has a little endometriosis (which can be the case if she hasn't been having normal periods for a while). I am not a doctor, but she might need to pose this question specifically to her doctor and see if she needs to have a D & C to clear her out. Good luck. -C