Ovarian cysts are common fluid-filled sacs that develop on or within an ovary. While many women experience them, most ovarian cysts are benign and often resolve without intervention. A frequent concern is whether these cysts can affect the ability to conceive. This article explores the types of ovarian cysts and their potential relationship with fertility.
Understanding Ovarian Cysts
Ovarian cysts are broadly categorized into two main types: functional cysts and pathological cysts. Functional cysts are the most common and typically form as a normal part of the menstrual cycle. These include follicular cysts, which arise when a follicle on the ovary fails to release an egg and continues to grow, and corpus luteum cysts, which form if the follicle that released the egg reseals and fills with fluid. Functional cysts are generally harmless, often asymptomatic, and tend to disappear on their own within a few menstrual cycles.
In contrast, pathological cysts are not related to the normal menstrual cycle and result from abnormal cell growth. Examples include dermoid cysts, which can contain various tissues like hair, skin, or teeth, and cystadenomas, which are filled with watery or mucous fluid and can grow quite large. Endometriomas, often called “chocolate cysts,” are formed by endometrial tissue growing on the ovaries. These pathological cysts may require medical attention or surgical removal depending on their size, symptoms, or potential complications.
Linking Cysts to Infertility
The connection between ovarian cysts and infertility depends on the type of cyst. Most common functional cysts do not cause infertility and often indicate that the ovaries are functioning as expected within the menstrual cycle. These cysts typically do not interfere with ovulation or conception.
However, certain pathological cysts and associated conditions can be linked to fertility challenges. Endometriomas, for instance, are associated with endometriosis, a condition where uterine-lining-like tissue grows outside the uterus. Endometriomas can impact fertility by potentially affecting egg quality, causing inflammation, or distorting the fallopian tubes.
Polycystic Ovary Syndrome (PCOS) is another condition frequently associated with ovarian cysts, though the cysts themselves are not the direct cause of infertility. PCOS is a hormonal disorder characterized by multiple small cysts on the ovaries, irregular periods, and elevated levels of certain hormones. Infertility in PCOS primarily stems from the underlying hormonal imbalance, which disrupts normal ovulation, rather than the presence of the cysts themselves.
Large cysts can also indirectly affect fertility. Their size might physically interfere with the normal functioning of the ovary or fallopian tube. If a large cyst requires surgical removal, the procedure itself, especially if not performed with fertility preservation in mind, could potentially impact ovarian reserve or cause adhesions that hinder conception.
When to Seek Medical Guidance
Recognizing symptoms associated with ovarian cysts and knowing when to consult a healthcare professional is important. Common symptoms include pelvic pain, bloating or fullness in the abdomen, pain during intercourse, or irregular menstrual periods. Some individuals may experience lower back or thigh pain, or a frequent need to urinate.
Immediate medical attention is necessary if sudden, severe abdominal or pelvic pain occurs, especially if accompanied by fever, vomiting, dizziness, or rapid breathing. These symptoms could indicate a ruptured cyst or ovarian torsion, where the ovary twists, cutting off its blood supply. Additionally, if you are experiencing difficulty conceiving, consulting a healthcare provider is advisable to investigate potential underlying causes, regardless of known cyst status. Diagnosis often involves a pelvic exam and an ultrasound, which can help determine the cyst’s size, location, and composition.
Management and Fertility Preservation
The approach to managing ovarian cysts varies based on their type, size, symptoms, and the individual’s fertility goals. For many small, asymptomatic functional cysts, “watchful waiting” is often recommended. This involves monitoring the cyst with follow-up ultrasounds to see if it resolves on its own, which most functional cysts do within a few months.
For conditions like PCOS, medical management often focuses on addressing the hormonal imbalances. This can involve hormonal therapies, such as birth control pills to regulate menstrual cycles and prevent new cyst formation, or medications to induce ovulation for those trying to conceive.
Surgical intervention may be considered for larger cysts, those causing severe symptoms, or if there is concern about malignancy. Laparoscopic surgery, a minimally invasive procedure, is often preferred for cyst removal (cystectomy) as it aims to preserve healthy ovarian tissue and minimize impact on fertility. In cases where fertility is a primary concern, surgeons strive to remove only the cyst while leaving the ovary intact. For individuals facing significant fertility challenges due to cysts, treatments like ovulation induction or in vitro fertilization (IVF) may be options to help achieve pregnancy. Discussing fertility goals with a healthcare provider is important when making treatment decisions.