Can Ovarian Cysts Cause Infertility?

If you have ovarian cysts, you may wonder, “Can ovarian cysts cause infertility?” This is a very valid question; many women develop ovarian cysts at some stage. However, the effect of these cysts on fertility varies depending on their type and size.

Ovarian cysts are very common, and many women experience them at some point in their lives. Most are harmless, causing no symptoms or pain, which is why they often go unnoticed and disappear over time without medical treatment. As a result, cysts in the ovary are usually only discovered during routine pelvic exams or ultrasounds.

Do ovarian cysts affect fertility? The brief answer is yes, in a few cases, this condition can affect the occurrence of pregnancy. However, the effect depends on the type of ovarian cyst. Certain cysts that develop in or on the ovary's surface are linked to lower pregnancy rates. 

Can Ovarian Cysts Cause Infertility?

Is there a link between ovarian cysts and infertility? Most ovarian cysts do not cause infertility and often resolve on their own without treatment. However, certain types of cysts, such as endometriomas or large, complex cysts, can affect your ability to conceive. 

Ovarian cysts generally do not cause infertility, which is why doctors typically only investigate further if a couple has been trying to conceive naturally through regular intercourse for a year without success, if under 35, or 6 months if over 35. 

If you are in such a situation or know someone who is, there are practical steps for trying to conceive (TTC) with ovarian cysts and guidance on when to seek medical care. Even if you’re not in such a situation, when planning for pregnancy, prioritizing your reproductive health is essential.

What Are Ovarian Cysts?

Ovarian cysts are fluid-filled sacs that form on or inside the ovaries, or semi-solid sacs that develop on or within an ovary. These cysts can form at any age and vary in shape and size. Usually, they resolve on their own.

Many women will have an ovarian cyst at some point in their lives, and the majority are harmless and a natural part of the menstrual cycle physiology. Understanding the type of cyst you have is the first step in determining its potential impact on your fertility.

For example, ovarian cysts resulting from polycystic ovary syndrome (PCOS) involve small cyst-like structures that result in a disrupted ovulation process. It can cause infrequent ovulation, affecting fertility. Polycystic ovaries are characteristic of PCOS, which leads to hormonal imbalances impacting ovulation and fertility.  

Women can have multiple ovarian cysts without having PCOS. Unlike PCOS, which causes a significant hormone imbalance, most ovarian cysts are either functional or nonfunctional. Not all ovarian cysts are created equal, a crucial distinction when assessing their impact on fertility. 

Functional vs. Nonfunctional Cysts

A woman who ovulates can develop about a one-inch cyst-like structure that is a dominant follicle that doesn’t rupture and release the egg that month. Not all cysts are harmful; most functional cysts are normal and resolve on their own. Nonfunctional (or pathological) cysts are less common and not related to the cycle. 

Here are the differences between the potential complications of ovarian cysts:

• Functional Cysts: These are the most common type of ovarian cyst and are directly related to the menstrual cycle. They indicate that your ovaries are functioning and preparing for ovulation. Functional cysts are usually harmless, rarely impact fertility, and often resolve within a few menstrual cycles. Having functional cysts generally does not indicate a fertility issue. There are two main types.

1. Follicular Cysts: These form when the follicle (the sac where an egg grows) doesn't rupture to release the egg and instead continues to persist.

2. Corpus Luteum Cysts: These occur when the follicle sac doesn't dissolve after releasing an egg and the opening seals up, allowing fluid to accumulate inside.

• Non-functional Cysts: These cysts are not related to the menstrual cycle and can have a more varied impact on fertility.

1. Endometriomas: These are cysts often associated with endometriosis and can be accompanied by pain. Endometriosis involves tissue similar to the uterine lining growing outside the uterus, forming endometrioma cysts that can impact fertility. These cysts are linked to difficulties becoming pregnant.

2. Dermoid Cysts: These are benign tumors that can contain various tissues, such as hair, skin, and teeth.

3. Cystadenomas: These are non-cancerous growths that can develop on the outer surface of the ovaries.

4. Hemorrhagic Cysts: These are blood-filled cysts that occur when there is bleeding into a cyst.

5. Malignant Cysts: In rare cases, an ovarian cyst can be cancerous.

Do Ovarian Cysts Cause Infertility?

While most ovarian cysts do not directly cause infertility, some types can. The impact of an ovarian cyst on fertility depends on several factors, including its type, size, location, and whether it requires surgical removal. Here’s a breakdown of how different cysts can affect fertility.

• Endometriosis can lead to infertility by altering the pelvic anatomy, creating an inflammatory environment that is hostile to sperm and eggs, and potentially affecting egg quality, quantity, and the process of ovulation and implantation.

• Large cysts can distort the ovary and interfere with its function. When considering your chances of pregnancy, keep in mind that repeated surgeries to remove cysts can lead to the loss of healthy ovarian tissue and the formation of adhesions, both of which can reduce your ovarian reserve (the number of eggs you have).

If you have been diagnosed with an ovarian cyst and are asking, "Can I get pregnant with an ovarian cyst?" a referral to a fertility specialist is recommended, especially if you have an endometrioma, a large cyst, or have undergone multiple ovarian surgeries.

Can I Get Pregnant With Ovarian Cysts?

Yes, many women with ovarian cysts conceive naturally. If you have a cystadenoma or a functional cyst, it's unlikely to affect your fertility. Your doctor might suggest "watchful waiting" with ultrasounds to monitor it. But if the cyst is large, conception may be discouraged due to the risk of ovarian torsion, a medical emergency.

Does an ovarian cyst affect pregnancy? Most ovarian cysts do not affect pregnancy because many are harmless and go away on their own; however, large or complex cysts can create risks such as ovarian torsion, rupture, and, in rare cases, hormonal imbalances that might interfere with pregnancy. 

Here is a checklist of questions to ask your doctor:

Chances of Getting Pregnant With Ovarian Cysts

Understanding your chances of pregnancy with an ovarian cyst starts with identifying the specific type of cyst you have. While many cysts are benign byproducts of the menstrual cycle, others may indicate underlying conditions that may affect fertility. The following table explains the typical effects of the most common cyst types on your ability to conceive.

The presence of a cyst is just one piece of your overall fertility puzzle. As the table illustrates, the impact can range from negligible to significant, often depending more on an associated condition like endometriosis than the cyst itself.

The link between ovarian cysts and pregnancy depends on other factors, including your age, overall ovarian reserve, and your partner's fertility, which can also significantly impact your chances of conceiving. A thorough evaluation with your doctor or a fertility specialist is the best way to understand your personal prognosis and create a tailored path forward.

How to Get Pregnant With Ovarian Cysts

If you know you have ovarian cysts and are finding it harder to conceive than expected, you might wonder why. Having a cyst on an ovary usually doesn't affect your chances of getting pregnant. But, in some cases, ovarian cysts can disrupt fertility. It depends on the type of cyst and your situation. Here is a step-by-step plan to help you on your journey to parenthood:

• Confirm Ovulation: Track your cycles using hormone monitors, apps, wands, a basal body temperature (BBT) thermometer, or ovulation predictor kits. If you have irregular cycles, your doctor may recommend ultrasound tracking to confirm ovulation.

• Optimize Your Lifestyle:

• Nutrition: Adopt a Mediterranean-style diet rich in fruits, vegetables, whole grains, and lean proteins. A simple way to help cover your bases is by incorporating a dedicated prenatal vitamin, such as Mira Prenatals with folic acid, to ensure your nutritional needs are met.

• Exercise: Aim for regular, moderate exercise on most days of the week.

• Sleep: Prioritize getting 7-9 hours of quality sleep per night.

• Stress Management: Incorporate stress-reducing activities into your routine, like yoga, meditation, or time in nature. Adding calm can be surprisingly beneficial. Consider a soothing ritual, such as a warm beverage in the evening. For many, a specially formulated herbal blend can make this time feel even more restorative. You might find sipping the Mira Fertility Tea, which contains herbs traditionally used to support hormonal balance, is an excellent, calming addition to your routine.

• Avoid Harmful Substances: Stop smoking and minimize alcohol consumption.

• Treat the Underlying Cause: If your cysts are caused by endometriosis, work with your doctor to create an individualized treatment plan.

• Surgery (If Necessary): If surgery is recommended, select a surgeon with experience in tissue-sparing cystectomy. Egg freezing is an option if there is a risk to your ovarian reserve.

• Seek Further Care: If you have been trying to conceive for 6-12 months without success (depending on your age), it may be time to consult a fertility specialist. They can discuss options such as intrauterine insemination (IUI) or in vitro fertilization (IVF).

Can Ovarian Cysts Cause Miscarriage?

For the most part, ovarian cysts do not cause miscarriage. The risk of miscarriage is more closely tied to huge cysts, complications like ovarian torsion or rupture, or the underlying condition causing the cyst (such as moderate to severe endometriosis). If you have a large cyst or a history of endometriosis, your doctor may recommend closer monitoring during early pregnancy. 

If you're managing cysts and worried about miscarriage or fertility issues, consulting your doctor is advisable. They can provide guidance, conduct tests, and suggest treatments to support your fertility journey.

Ovarian Cysts IVF

When a woman undergoing IVF has an ovarian cyst, it introduces an extra layer of complexity to the treatment plan. The presence of a cyst can affect both the timing and the outcome of the cycle, and the appropriate management depends entirely on the type and size of the cyst. Ovarian cysts can sometimes complicate IVF treatment:

• A large functional cyst may delay the start of an IVF cycle. In some cases, your doctor may recommend aspirating (draining) the cyst.

• The decision to remove an endometrioma before IVF is highly individualized. While surgery can improve access to the follicles during egg retrieval, it also carries the risk of reducing your ovarian reserve. Your doctor will make a recommendation based on your age, ovarian reserve (AMH/AFC), and symptoms.

Symptoms & When to See a Doctor

Many ovarian cysts cause no symptoms at all and are discovered incidentally during a routine pelvic exam or ultrasound. When symptoms of an ovarian cyst do occur, they can range from common symptoms to emergency signs. It's important to distinguish between common symptoms that require a doctor's visit and urgent signs that demand immediate medical attention.

Common Symptoms

• Pelvic pressure or pain

• Bloating

• Pain during intercourse (dyspareunia)

• Spotting between periods

• Changes in urinary or bowel habits, or irregular cycles.

Emergency Symptoms

Seek immediate medical attention if you experience sudden, severe pelvic pain, faintness, dizziness, nausea, vomiting, or a rapid heartbeat. These could be symptoms of a ruptured ovarian cyst or ovarian torsion.

Ovarian cyst pain can range from a dull ache to sudden, severe pain, often on one side of the lower abdomen, and is sometimes accompanied by bloating, pain during intercourse, or painful bowel movements.

If you're managing ovarian cysts and are concerned about their potential long-term impact on your fertility, even if you're not experiencing an immediate crisis, it's wise to get professional advice. For personalized insights and a deep dive into your specific situation, you can schedule an appointment with a hormone health practitioner. They can offer tailored fertility support and help you create a proactive plan. 

Diagnosis & Monitoring

The standard process for diagnosing and monitoring ovarian cysts includes:

• Pelvic Exam: Your doctor may be able to feel a cyst during a routine pelvic exam.

• Transvaginal Ultrasound: This is the most common imaging test used to diagnose ovarian cysts.

• Follow-up Imaging: Your doctor may recommend a repeat ultrasound in a few weeks or months to see if the cyst has resolved or changed in size.

• Lab Tests and MRI: In some cases, blood tests for tumor markers or an MRI may be ordered to get more information about the cyst.

Treatment Options & Fertility Considerations

The correct treatment for an ovarian cyst varies. Your doctor considers the cyst's type, size, symptoms, and your family's goals. The aim is to treat the cyst effectively while preserving fertility as much as possible.

• Watchful waiting: This is recommended for most functional cysts.

• Symptomatic management: Over-the-counter pain relievers can help manage mild pain.

• Hormonal contraception: Birth control pills can help prevent the formation of new functional cysts. Still, they also prevent ovulation, so this is not an option if you are actively trying to conceive.

• Surgery: Surgery may be recommended for cysts that are large, persistent, cause significant pain, or are suspicious for cancer. When considering surgery, it is crucial to choose an experienced surgeon who uses microsurgical techniques to minimize damage to the ovary and prevent adhesions.

Conclusion

Ovarian cysts can create a complex situation. While the diagnosis of an ovarian cyst can be concerning when you are trying to conceive, it is essential to remember that most cysts do not impact fertility. By working with your healthcare provider to understand the type of cyst you have and to develop a personalized plan, you can take proactive steps to optimize your chances of a successful pregnancy.

Frequently Asked Questions 

Is there a link between dermoid ovarian cysts and fertility issues or difficulty conceiving?

Dermoid cysts are not typically associated with fertility issues unless they grow huge and distort the ovarian anatomy or require surgical removal, which could damage the ovarian tissue.

Can an ovarian cyst, that isn't treated, lead to infertility?

Most untreated functional cysts resolve independently and don't cause infertility. However, a link between ovarian cysts and infertility can involve untreated endometriomas that can worsen and potentially cause infertility, while large untreated cysts might also damage the ovary, impacting fertility.