An ovarian cyst is a fluid-filled sac that develops on or within an ovary. Ovarian cysts are common, often asymptomatic. While they can raise fertility concerns, most are benign and do not significantly impact conception or pregnancy.
What Are Ovarian Cysts?
Ovarian cysts are fluid-filled sacs that form on or inside the ovaries. Many are asymptomatic and resolve on their own. Cysts can be broadly categorized into functional and pathological types.
Functional cysts are the most common, arising as a normal part of the menstrual cycle. Follicular cysts form when a follicle doesn’t rupture to release an egg, growing and filling with fluid. Corpus luteum cysts develop after an egg is released, with the remaining sac filling with fluid instead of shrinking. These functional cysts usually disappear within a few months.
Pathological cysts are less common, forming due to abnormal cell growth unrelated to the menstrual cycle. Examples include endometriomas, filled with menstrual blood and linked to endometriosis, and dermoid cysts, which can contain various tissues like hair or skin.
Cysts and Your Ability to Conceive
While many ovarian cysts do not affect fertility, certain types can make conception more challenging. The impact depends on the cyst’s type, size, and underlying cause. Functional cysts, being part of the normal menstrual cycle, typically do not hinder fertility.
However, cysts associated with Polycystic Ovary Syndrome (PCOS) can affect fertility. PCOS involves hormonal imbalances leading to irregular or absent ovulation, reducing conception chances.
Endometriomas, also known as “chocolate cysts,” are another type impacting fertility. These cysts, formed by uterine-lining-like tissue on the ovaries, can damage ovarian tissue, affect egg quality, and cause inflammation or adhesions that interfere with fallopian tube function.
Large cysts, regardless of type, can also mechanically obstruct fallopian tubes or interfere with egg release, complicating conception. Pelvic adhesions, bands of scar tissue from cyst removal or endometriosis, can also cause infertility by binding reproductive organs and obstructing the egg’s path.
Ovarian Cysts During Pregnancy
It is common for ovarian cysts to be discovered during pregnancy, often incidentally during routine prenatal ultrasounds. The majority are harmless and do not cause problems for the mother or baby.
Functional cysts, such as corpus luteum cysts, are common in early pregnancy and support hormone production before the placenta takes over. Most functional cysts found during pregnancy resolve on their own, often by the second trimester. Larger or more complex cysts may be monitored with follow-up ultrasounds.
While rare, potential complications include ovarian torsion (when the ovary twists on its blood supply), cyst rupture, or, in very large cases, obstruction during delivery. Ovarian torsion is a medical emergency requiring prompt attention. Despite these potential complications, most cysts found during pregnancy do not lead to significant issues.
Pathways to Parenthood with Cysts
Navigating fertility and pregnancy with ovarian cysts involves individualized medical guidance and various management approaches. For many functional cysts, “watchful waiting” is common, as they often resolve without intervention. This involves monitoring the cyst with follow-up ultrasounds to ensure it is shrinking or remains stable.
When cysts impact fertility, such as those associated with PCOS, medical management focuses on addressing hormonal imbalances and promoting ovulation through medications. For certain pathological cysts or those causing significant symptoms or complications, surgical intervention may be considered.
This can involve laparoscopic surgery to remove the cyst while preserving the ovary, aiming to maintain fertility. Treatment decisions, medical or surgical, are made in consultation with healthcare providers, including gynecologists and fertility specialists, based on the cyst’s type, characteristics, and individual reproductive goals. Many individuals with ovarian cysts successfully achieve pregnancy and have healthy deliveries.