Ovarian cysts are fluid-filled sacs that develop within or on an ovary. They are common, particularly during reproductive years. While some cause pelvic pain or pressure, many produce no symptoms. Most ovarian cysts are benign and resolve on their own. This common occurrence often raises questions about their potential impact on fertility.
Understanding Ovarian Cysts
Ovarian cysts form as a natural part of the menstrual cycle or due to abnormal cell growth. Functional cysts are the most frequent type, arising from normal hormonal fluctuations during ovulation. Follicular cysts develop when a follicle fails to rupture and release the egg, continuing to grow. Corpus luteum cysts form if the corpus luteum fills with fluid after ovulation. These functional cysts are harmless and temporary.
Beyond functional types, other cysts stem from different origins. Endometriomas are cysts filled with endometrial-like tissue that grows on the ovary. Dermoid cysts can contain various tissues like hair, skin, or teeth, originating from embryonic cells. While these pathological cysts are not necessarily cancerous, their characteristics distinguish them from functional cysts.
How Specific Cysts Impact Fertility
Certain ovarian cysts can interfere with conception. Endometriomas, associated with endometriosis, significantly affect fertility. These cysts can distort ovarian and fallopian tube anatomy, hindering egg release or travel for fertilization. The inflammatory environment created by endometriosis may also impair egg quality or interfere with embryo implantation.
Large ovarian cysts can impede ovulation by occupying space within the ovary. A large cyst can also press on or displace the fallopian tube, potentially blocking the egg’s path to the uterus. In rare instances, a large cyst could compromise the ovary’s blood supply, affecting its function. Surgical removal of some cysts carries a risk of inadvertently reducing ovarian reserve by removing healthy ovarian tissue.
Polycystic Ovary Syndrome (PCOS) involves multiple small follicles, but underlying hormonal imbalance causes infertility, not the follicles themselves. Individuals with PCOS often experience anovulation due to elevated androgen levels and insulin resistance. While “cysts” are part of the syndrome’s name, infertility results from disrupted ovulation rather than direct physical obstruction by these follicles.
Ovarian Cysts Not Linked to Infertility
Most ovarian cysts are functional and do not cause infertility. Follicular cysts are common, forming when a follicle grows but does not rupture to release an egg. These cysts resolve within weeks, without symptoms, and do not impair future ovulation or fertility. Corpus luteum cysts, which develop after egg release and the remaining follicle fills with fluid, are also temporary and benign.
Functional cysts are a normal part of the menstrual cycle and do not indicate an underlying fertility problem. They do not physically block fallopian tubes, nor do they negatively impact egg quality or ovarian function. Their temporary nature means they disappear before the next menstrual cycle, allowing normal ovulation to resume. Discovering a functional ovarian cyst does not warrant concern regarding conception.
Many other benign, non-functional cysts also do not directly threaten fertility. Unless they grow large or cause significant anatomical distortion, most do not interfere with ovulation or reproduction. Differentiating these harmless cysts from types that can impact fertility, like endometriomas, is important for accurate assessment and management.
Diagnosis and Management for Fertility Concerns
When an ovarian cyst is suspected of impacting fertility, diagnosis begins with a pelvic ultrasound to visualize its size, shape, and characteristics. Blood tests, such as CA-125, may assess markers, though CA-125 is not primarily for fertility assessment and can be elevated for benign reasons. Healthcare providers evaluate these findings with a patient’s medical history and symptoms to determine potential fertility impact.
For many cysts, especially functional ones, watchful waiting is recommended, allowing time for the cyst to resolve. If a cyst persists, grows, or is suspected of hindering fertility, treatment options are considered. Surgical intervention, typically laparoscopy, removes the cyst while preserving healthy ovarian tissue (cystectomy).
In rare, complex cases, if a cyst is large or highly suspicious, removal of the entire ovary (oophorectomy) may be considered, though fertility preservation remains a primary goal. For PCOS-related fertility issues, management includes non-surgical approaches to restore regular ovulation, such as lifestyle modifications and medications like clomiphene or letrozole. Consulting a healthcare professional is important for individuals with concerns about ovarian cysts and fertility.