Ovarian cysts are common fluid-filled sacs that can develop on the ovaries. Many women experience them at some point in their lives, often without symptoms. While ovarian cysts are common, their presence does not typically prevent pregnancy, and most women conceive naturally or with medical assistance. However, the impact on fertility can vary significantly depending on the specific type of cyst and any underlying conditions.
Types of Ovarian Cysts and Their Fertility Link
Ovarian cysts are broadly categorized into functional and pathological types, with varying implications for fertility. Functional cysts are the most common and typically do not affect conception. These include follicular cysts, which form when a follicle does not release an egg and continues to grow, and corpus luteum cysts, which develop if the follicle sac re-seals after releasing an egg and fills with fluid. Both types are a normal part of the menstrual cycle and usually resolve on their own within a few months without intervention.
In contrast, pathological cysts are less common and may sometimes be associated with fertility challenges. Endometriomas, often called “chocolate cysts,” are linked to endometriosis, a condition where uterine-lining-like tissue grows outside the uterus. Dermoid cysts, which can contain various tissues like hair or skin, and cystadenomas, fluid-filled growths on the ovary’s surface, are generally not linked to infertility unless they become very large or require extensive surgical removal. Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by multiple small cysts on the ovaries, and it is frequently associated with fertility difficulties due to its impact on ovulation.
How Ovarian Cysts Can Influence Conception
Ovarian cysts can influence conception through several mechanisms, often by disrupting ovulation. This process, where an egg is released from the ovary, can be prevented or irregularized by large cysts or hormonal imbalances, as seen in conditions like PCOS. In PCOS, for instance, high levels of certain hormones can interfere with the normal development and release of an egg.
Physical interference from cysts can also play a role. Very large cysts or endometriomas might physically block the fallopian tubes, preventing the egg from traveling to the uterus or sperm from reaching the egg. Such cysts can also distort the normal anatomy of the ovary, potentially impeding egg release.
Conditions like endometriosis, which can cause endometriomas, may lead to inflammation, scar tissue formation, or adhesions that interfere with the function of the ovaries and fallopian tubes. These factors can affect egg quality, alter the uterine lining, or disturb hormonal balance necessary for pregnancy. Additionally, symptoms such as pelvic pain or discomfort, which some cysts can cause, might indirectly affect conception by reducing the frequency of intercourse.
Navigating Pregnancy Attempts with Cysts
When attempting to conceive with ovarian cysts, healthcare providers typically begin with diagnosis and monitoring. Ovarian cysts are often discovered during routine pelvic examinations or, more commonly, through ultrasound imaging. An ultrasound can help assess the cyst’s size, characteristics, and whether it appears benign. Sometimes, blood tests may also be conducted to check hormone levels or specific markers, especially if there’s concern about underlying conditions like PCOS or endometriosis.
Management strategies for cysts impacting fertility vary based on the cyst type and its effect. Functional cysts often resolve without treatment, so a “watchful waiting” approach with follow-up ultrasounds is common. For symptomatic or problematic cysts, treatment options include hormonal medications, which can help regulate the menstrual cycle and prevent new cysts from forming, particularly in conditions like PCOS. Surgical removal, known as a cystectomy, may be recommended for large, persistent, or symptomatic cysts, or those suspected of being pathological. Surgeons aim to preserve as much healthy ovarian tissue as possible during these procedures to maintain fertility.
For individuals facing significant fertility challenges due to cysts or associated conditions, assisted reproductive technologies (ART) like in vitro fertilization (IVF) may be considered. IVF can bypass issues like blocked fallopian tubes and help achieve pregnancy, even with some types of cysts present.
When to Consult a Healthcare Provider
It is advisable to consult a healthcare provider if you experience persistent symptoms that might suggest an ovarian cyst. These symptoms can include ongoing pelvic pain, bloating, irregular menstrual periods, or changes in bowel or bladder habits. Such symptoms, even if benign, warrant evaluation for proper management.
Seeking medical advice is especially important if you have been actively trying to conceive without success. Generally, if you are under 35 and have been trying for a year, or over 35 and trying for six months, it is recommended to discuss fertility concerns with a doctor, particularly if you know or suspect you have ovarian cysts.
Immediate medical attention is necessary for sudden, severe abdominal or pelvic pain, especially if accompanied by fever, vomiting, dizziness, or weakness. These could be signs of a ruptured cyst or ovarian torsion, where the ovary twists, cutting off its blood supply, both of which are medical emergencies. Pre-conception counseling can also be beneficial to discuss any existing cysts or fertility concerns before actively trying to become pregnant.