Ovarian cysts are fluid-filled sacs that can develop on or within an ovary. These growths are common and often do not cause any symptoms. Many ovarian cysts are harmless and resolve on their own without the need for medical intervention.
Common Types of Ovarian Cysts
Ovarian cysts are broadly categorized into functional cysts and pathological cysts, each with distinct characteristics. Functional cysts are the most frequently occurring type and a normal part of the menstrual cycle. These include follicular cysts, which form when a follicle fails to release an egg, and corpus luteum cysts, which develop after an egg has been released. Functional cysts typically disappear within a few menstrual cycles and usually do not impact fertility.
In contrast, pathological cysts are not related to the normal menstrual cycle and can form due to abnormal cell growth or underlying conditions. Dermoid cysts, also known as teratomas, can contain various tissues like skin, hair, and even teeth. While often benign, dermoid cysts do not typically resolve on their own and may require surgical removal if they grow large.
Another type of pathological cyst is the cystadenoma, which forms on the surface of the ovary. These cysts can be filled with watery fluid or a thicker, mucous-like substance and are generally benign. They can grow quite large but are not typically linked to infertility.
Endometriomas, commonly called “chocolate cysts,” are filled with dark, old blood and are a manifestation of endometriosis. This is a condition where tissue similar to the uterine lining grows outside the uterus. Endometriomas are frequently associated with endometriosis and can cause symptoms like pelvic pain and irregular periods.
Direct and Indirect Impacts on Fertility
While many ovarian cysts are harmless, some types or associated conditions can affect fertility. The impact depends on the specific type, size, and location of the cyst. Small, functional cysts generally do not interfere with fertility and often resolve without intervention.
Larger cysts, particularly certain pathological types, can directly impact fertility through physical obstruction or damage. A large cyst can block a fallopian tube, preventing the egg from traveling to the uterus. In some cases, a large cyst or one that ruptures can damage ovarian tissue.
Ovarian cysts often affect fertility indirectly through underlying conditions. Polycystic Ovary Syndrome (PCOS) is a hormonal disorder characterized by multiple small follicles on the ovaries. PCOS can lead to irregular or absent ovulation, which prevents the regular release of mature eggs.
Endometriomas are linked to endometriosis, a condition that can impair fertility. Endometriosis can cause inflammation, scar tissue (adhesions), and distortion of the pelvic anatomy. These factors hinder the normal function of the ovaries and fallopian tubes, making conception challenging. Certain cysts or underlying conditions can also disrupt the hormonal balance necessary for successful conception, affecting ovulation and egg quality.
Diagnosis and Treatment Approaches
Diagnosing ovarian cysts involves medical evaluations. A pelvic exam may detect an enlarged ovary or tenderness. Ultrasound is the primary diagnostic tool, providing images to assess the cyst’s size, shape, and characteristics. Blood tests may also be performed, such as checking for specific markers like CA-125 or hormone levels, especially if PCOS is suspected.
Treatment approaches for ovarian cysts vary based on the cyst type, size, symptoms, and fertility concerns. For many asymptomatic functional cysts, “watchful waiting” is adopted, as they often resolve on their own within a few months. Medications, such as hormonal birth control, may prevent new cysts, though they do not typically treat existing ones. For underlying conditions like PCOS, specific medications may regulate hormones and induce ovulation.
Surgical intervention is considered for large cysts, those that persist, or cysts causing significant symptoms or fertility issues. Surgery can be performed using minimally invasive laparoscopic techniques or, less commonly, open surgery. For fertility-related concerns, treatments for underlying conditions, such as ovulation induction for PCOS, or surgical removal of certain cysts like endometriomas, can improve conception chances.
When to Consult a Healthcare Professional
Consult a healthcare professional if you experience symptoms that indicate an ovarian cyst. These symptoms include persistent pelvic pain, sudden severe abdominal pain, bloating, or changes in your menstrual cycle. Unexplained weight changes or feeling full quickly after eating small amounts are also reasons to seek medical advice.
If you are trying to conceive and have been unsuccessful for six to twelve months, depending on age, consult a doctor. This is important if you have a history of ovarian cysts or suspect an underlying condition that could affect fertility. Early diagnosis and management of ovarian cysts and associated conditions benefit both overall health and fertility outcomes.