Ovarian cysts are common, fluid-filled sacs that develop on or within an ovary. While many women experience them, most cysts do not prevent pregnancy. The impact of an ovarian cyst on a woman’s ability to conceive depends on its type and underlying cause. This article explores ovarian cysts and their potential influence on fertility.
Understanding Ovarian Cysts
An ovarian cyst is a fluid-filled sac that forms on or inside an ovary. Cysts are categorized into two main types: functional and pathological. Functional cysts are the most common and are directly related to the menstrual cycle. They are considered a normal part of ovarian function.
Functional cysts include follicular and corpus luteum cysts. A follicular cyst forms when a follicle, which normally releases an egg during ovulation, fails to rupture and continues to grow. A corpus luteum cyst develops after an egg has been released, when the follicle transforms into the corpus luteum and fluid accumulates. These cysts are typically harmless and often resolve without intervention.
Pathological cysts are not linked to the menstrual cycle and arise from abnormal cell growth. These are less common but may require medical attention. Examples include endometriomas, dermoid cysts, and cystadenomas, which are fluid-filled cysts that grow on the ovary’s surface. While most pathological cysts are benign, a small number can be cancerous.
How Cysts Can Impact Fertility
While many cysts are harmless, certain types of ovarian cysts or the underlying conditions that cause them can interfere with conception. Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by multiple small follicles on the ovaries, often referred to as cysts. PCOS can prevent regular ovulation due to hormonal imbalances, making it difficult to conceive.
Endometriomas, also known as “chocolate cysts,” are another type of cyst that can affect fertility. These cysts are associated with endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, including on the ovaries. Endometriomas can distort pelvic anatomy, cause inflammation, and potentially impair egg quality or ovarian function, hindering conception.
Large or complex cysts might also physically obstruct the fallopian tubes or interfere with the ovary’s ability to release an egg. Surgical removal of such cysts can sometimes lead to a reduction in ovarian reserve if healthy ovarian tissue is inadvertently removed. In rare cases, a large cyst can lead to ovarian torsion, where the ovary twists on its blood supply, potentially damaging the ovary and affecting fertility if not promptly treated.
When Cysts Typically Don’t Affect Conception
Most ovarian cysts do not prevent pregnancy and are a normal part of a woman’s reproductive cycle. Functional cysts, such as follicular and corpus luteum cysts, are common and usually disappear on their own within one to three menstrual cycles. These cysts form as part of the natural process of ovulation and do not interfere with an egg’s release or a woman’s ability to conceive.
Their presence often indicates that the ovaries are functioning as expected. Many women become pregnant naturally even after being diagnosed with these common functional cysts. Small dermoid cysts and cystadenomas also rarely impact a woman’s ability to get pregnant. The key difference lies in whether the cyst is a temporary, physiological occurrence or a persistent growth that disrupts the reproductive system.
Steps for Conception with Ovarian Cysts
When ovarian cysts are present or suspected while trying to conceive, medical evaluation is an important first step. For functional cysts, a “watchful waiting” approach is often recommended, as they typically resolve spontaneously. Monitoring with follow-up ultrasounds can confirm their disappearance.
For cysts that do affect fertility, such as those associated with PCOS or endometriomas, specific treatments can improve conception chances. Hormonal medications, like clomiphene or letrozole, can help stimulate ovulation in women with PCOS. Surgical removal of cysts, particularly large, symptomatic, or fertility-impacting endometriomas, may be considered. Laparoscopic surgery is a minimally invasive technique often used to remove cysts while aiming to preserve healthy ovarian tissue. It is important to discuss individual circumstances with a healthcare professional to determine the most appropriate course of action, as treatment decisions can depend on the cyst type, size, symptoms, and fertility goals.