Around 7% of women experience an ovarian cyst at some point, so if you have questions about ovarian cysts and infertility, you’re not alone.
Some ovarian cysts may be associated with decreased fertility because they can affect a woman’s hormones or ovulation cycle.
As per the American Society for Reproductive Medicine, ovulation dysfunction accounts for one in four infertility cases.
So which types of cysts are problematic and how do cysts form in the first place? Here you will find answers to these questions and learn how to manage or identify the symptoms.
What are ovarian cysts?
Why do ovarian cysts form?
To understand this, you must first understand the female reproductive cycle. Typically, the follicles in a woman’s ovaries grow and release an egg cell about 12-14 days before the next cycle.
The egg comes from a small, fluid-filled sac inside the ovary called an ovarian follicle. The follicle fluid protects the egg as it grows and eventually, it breaks open to release the egg into the fallopian tube.
Cysts can form when the follicle doesn’t burst and the sac continues growing inside the ovary. They can also form after the egg is released if the sac doesn’t go away on its own. It keeps swelling and the fluid collects. This can lead to ovarian cysts.
Hormonal imbalances and certain conditions can also encourage cysts to form. Fertility drugs can also cause multiple follicles (cysts) to develop in the ovaries.
Types of ovarian cysts
Some ovarian cysts are more common than others. Here’s a look at the different types and what causes ovarian cysts.
Cysts that form each month as and when the follicle grows are called functional ovarian cysts. These are common and are a normal part of the menstrual cycle. Usually, they are harmless and do not affect fertility.
There are two types of functional cysts: follicular and corpus luteum cysts.
- Follicular cysts
These are the most common type of ovarian cysts. When the ovarian follicle fails to release its egg, it may continue to swell into a large follicular cyst. Most follicular ovarian cysts grow to be 2–5 cm in diameter or larger, then go away on their own. In rare cases, they get bigger and can require surgery.
- Corpus luteum cysts
After ovulation, the empty sac forms what is called the corpus luteum. This corpus luteum makes hormones to prepare the body for pregnancy. Normally, if the egg is not fertilized, it breaks down. But sometimes, it doesn’t dissolve. Rather, it begins filling with fluid and forms a corpus luteum cyst.
Over time, these cysts go away on their own, usually within a few months. However, they can grow to be large and cause pelvic pain and bleeding.
Any other kind of cysts are considered abnormal. In some cases, they can be serious and may adversely affect your fertility.
- Hemorrhagic cysts
Hemorrhagic ovarian cysts develop during ovulation when an egg is released through an ovarian follicle, and that follicle fills with blood forming a cyst.
Doctors don’t know why this happens and most often, hemorrhagic cysts do not cause symptoms. In fact, women may not even know they have them. Hemorrhagic cysts usually go away on their own.
These are cysts that form in endometriosis, a condition where uterine tissue called endometrium starts growing outside the uterus. It is usually associated with low progesterone levels. These types of ovarian cysts may be linked with fertility issues.
- Ovarian cysts caused by polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a medical condition in which small cysts develop on your ovaries. It can cause irregular periods. PCOS can make it difficult to get pregnant because it interferes with how your eggs are released from your ovaries. PCOS is associated with an excess of male hormones, like testosterone, called androgens.
Can ovarian cysts cause infertility?
Some types of ovarian cysts are associated with hormonal imbalances that affect your ability to get pregnant. For instance, endometriomas can affect fertility. Also PCOS hampers your ability to get pregnant.
Moreover, the size, number, and location of the cysts can cause complications. In serious cases, ovarian cysts may rupture. Internal bleeding from a ruptured cyst could lead to scarring and ovary damage. It may interfere with ovulation or implantation.
Ovarian cysts can also block the fallopian tubes which makes it difficult for sperm to reach the egg. In some cases, cysts produce hormones that can interfere with ovulation.
How is an ovarian cyst diagnosed?
If you have ovarian cyst symptoms, your doctor may use the following tests to diagnose ovarian cysts:
- Pelvic exam: During a pelvic exam, your doctor may feel inside your lower abdomen for lumps or changes.
- Ultrasound (sonogram): If your exam is abnormal or you have symptoms that suggest something is wrong, your doctor may order an ultrasound (US) to look inside the abdomen. Two types of US that may be used for cysts are the abdominal US and the transvaginal US.
- Laparoscopy: Laparoscopy is a minimally invasive technique that uses small cuts or incisions to insert a small, lighted instrument into the pelvic cavity to view the ovaries and look for abnormalities.
How can I manage ovarian cysts?
If you are diagnosed with an ovarian cyst, visit your doctor regularly so they can monitor your cyst and provide treatment when necessary.
Remember that most cysts are harmless. Depending on your age and the size and type of cyst you have, as well as your symptoms, treatment may vary.
Most often, conservative management is the best way to treat ovarian cysts. If you have a small cyst and no symptoms, your doctor will most likely recommend waiting a few months to see if the cyst goes away. You may need several follow-up exams to check whether your cyst changes in size or appearance.
Hormonal contraceptives, or birth control pills, prevent you from ovulating. In other words, they could stop you from getting more ovarian cysts. Also, if ovarian cysts are causing pain, you can take over-the-counter pain medicines for relief.
If your cyst is not functional and is growing or causing pain, your provider may suggest removing it. In some cases, only the cyst needs to be removed (cystectomy), but sometimes the ovary along with the attached cyst will also need to be removed (oophorectomy).
Studies show that surgery to remove a cyst is often more harmful than the cyst itself. A minimally invasive laparoscopic procedure is the best option if a surgical procedure is required.
Laparoscopy is performed with a thin telescope-like device and instruments inserted through tiny cuts in your stomach. Open surgery may be required if the cyst is too large to remove through the small incisions or if cancer is present.
When do ovarian cysts require medical intervention?
If you have the following symptoms after being diagnosed with an ovarian cyst, you might need a doctor’s evaluation:
- Pelvic pain that is dull, aching, or sharp in the lower abdomen where the cyst is
- A feeling of fullness or heaviness in your lower abdomen/pelvic region
- Abdominal bloating or swelling
- Your doctor can perform an exam and tell you what to do next.
If left unchecked, some ovarian cysts can grow to the point where they pull on the ovary. This may lead to painful ovarian torsion (twisting) of the ovary and disrupt blood flow. Cysts can also rupture, causing severe pain and internal bleeding.
Seek immediate medical attention if you experience these symptoms:
Sudden, severe abdominal or pelvic pain
Fever or vomiting
Signs of shock such as cold and clammy skin, dizziness, or rapid breathing
These symptoms could indicate that the cyst has ruptured, or caused the ovary to twist (ovarian torsion).
- Ovarian cysts may form in your body naturally as a part of normal reproduction.
- Most ovarian cysts are harmless.
- Some cysts can be associated with certain medical conditions that cause problems like hormone changes. Abnormal hormone levels can be related to infertility.
- In rare emergencies, cysts can rupture or cause damage to the ovary.
If you’re concerned about your hormone levels or your chances of getting pregnant, try Inito for accurate results. Your doctor can also recommend blood or urine testing upon physical evaluation.
Writer’s Note: This content is meant to be informative but does not constitute medical advice. It is not intended for use as diagnosis, prevention, or treatment of health problems. If you have concerns about your health or medical conditions, talk with your doctor.