Can Ovarian Cysts Cause Infertility?

The female reproductive system is complex in many ways. Each of its parts is interdependent and works together to support conception and pregnancy. It can also be a key indicator of other health problems within the rest of the body. The ovaries play an essential part and any small change can affect the whole body. 

Let’s examine ovarian cysts, a very common condition that affects females’ ovaries. 

Key Takeaways

• Ovarian cysts are small, fluid-filled sacs that can form on the ovary and are typically benign.
• While most ovarian cysts resolve on their own, some forms of cysts can be harmful and require medical intervention.
• While cysts rarely cause complications, they can be an indication of serious disorders like endometriosis and polycystic ovarian syndrome.

What Is an Ovarian Cyst?

An ovarian cyst is a little sac that forms in the ovaries filled with fluid. These cysts come in different sizes and are usually benign. Some benign cysts go away on their own without causing any symptoms. However, they can cause problems when they rapture or they grow large enough to prevent day-to-day living. Fortunately, most of these don’t pose a threat to fertility. Ovarian cysts are only visible during routine pelvic examinations or ultrasounds. 

Types of Ovarian Cysts

There are two main types of ovarian cysts - functional cysts and non-functional cysts. It is important to understand each type as each may come with different symptoms and subsequent treatment. 

Functional Cysts

Functional ovarian cysts are the most popular type of ovarian cysts. Functional cysts appear as a woman menstruates, when an ovary either fails to release an egg or the structure on which an egg matures continues to grow after releasing its egg.

Eggs stored in the ovary, known as oocytes, develop inside tiny, fluid-filled sacs called follicles. Each month, during reproductive years, several follicles start to grow and develop. During ovulation, one follicle reaches full maturity and ruptures, releasing an egg. In some cases, ovulation doesn’t go according to plan and the egg fails to release. The follicle can also continue to grow forming a cyst. 

It is difficult to know whether you have a functional ovarian cyst unless an ultrasound is done. This is because most functional ovarian cysts resolve themselves on their own.  

Functional cysts can be categorized into:

• Follicular cysts. These form when the follicle stays intact and the cyst continues to grow instead of releasing an egg.
• Corpus luteum cysts. These sometimes form after ovulation once the egg has broken free and the follicle shrinks into a mass of cells known as the corpus luteum. The Corpus luteum produces hormones to prepare for the next cycle and the luteal cysts form when, instead of shrinking, the follicle reseals itself and fluid builds up inside.

Non-Functional

Non-functional ovarian cysts are either benign or can be an indication of more serious issues.  Functional ovarian cysts include: 

Endometriomas

Also known as “chocolate cysts”, endometriomas form when endometrial tissue forms outside of the uterus due to endometriosis, particularly in more advanced and serious cases of endometriosis, and are an indication that other complications from the disease might be present. A 2010 study found subjects with endometriosis were significantly more likely to experience infertility, although the specific link between endometriosis and fertility has not been fully understood. While there is no cure for endometriosis, there are surgical and medication-based treatments that can address its symptoms and minimize its impacts.

Polycystic Ovarian Syndrome (PCOS) 

PCOS is a condition that affects around 20% of women. With this condition, a number of tiny cysts form on the ovaries. While the cysts themselves may not need to be removed, PCOS symptoms can have long-term effects that include weight gain, acne, excessive hair growth, baldness, extreme tiredness, and difficulties conceiving. Similar to endometriosis, PCOS has no cure but its symptoms can be treated with medication-based therapy.

Cystadenomas 

According to the National Institute of Health, ovarian cystadenomas are quite common and rarely come with complications. These are small benign tumors filled with a clear, mucus-like liquid that often present no symptoms, and can be easily removed through surgery if complications arise. 

Symptoms of Ovarian Cysts

As already mentioned, most ovarian cysts do not present any symptoms, and many people go about their lives unaware they have a cyst at all. Nevertheless, sometimes the cyst grows too large or even ruptures. Symptoms of a large or ruptured cyst include:

• A sudden, sharp pain in the lower belly or back
• Vaginal spotting or bleeding
• Abdominal bloating
• Menstrual irregularities

Seek emergency medical attention if the pain is accompanied by:

• Fever which could be a sign of infection
• Severe nausea and vomiting, which could be a sign of an ovarian torsion
• Fever (may indicate infection)
• Heavy vaginal bleeding
• Faintness or dizziness

Treating Ovarian Cysts

Having an ovarian cyst doesn’t necessarily mean you will not be able to conceive. Even with an ovarian cyst that could potentially lead to fertility issues,  Ivy Fertility has a number of treatment options available to promote the likelihood of becoming pregnant. 

Treatment options offered to patients with ovarian cysts include the following.

Monitoring

Many cysts are benign and asymptomatic, which means they don’t require immediate treatment. Healthcare professionals monitor such cysts using ultrasound examinations to prevent any potential issues in the future. The most common treatment of ovarian cysts is time. Healthcare professionals recommend waiting a few months only if the cyst is asymptomatic and does not cause other issues. Many times, the cyst will resolve on its own. 

Hormonal treatments

Hormonal treatments like oral contraceptives or gonadotropin-releasing hormone agonists (GnRH) are commonly used as preventive measures. These help to regulate the menstrual cycle and inhibit ovulation to prevent cysts from forming in the first place. 

Surgery

When large or complex ovarian cysts are present, the only solution may be surgical intervention. For starters, laparoscopic surgery (an invasive surgery) is used to make small incisions in the abdomen, insert a thin, flexible tube with a camera, and remove the cysts. If the cysts are cancerous or too large, open surgery may be the only option. 

Do Ovarian Cysts Cause Infertility?

Most ovarian cysts do not cause infertility on their own, but for women looking to conceive, being aware of the potential impacts of ovarian cysts on fertility is essential. Ovarian cysts can cause infertility by:

• Blocking the ovary from releasing an egg, which is necessary for fertilization and pregnancy. 
• Creating hormonal imbalances that can affect ovulation. 
• Causing pain and discomfort, which can make intercourse difficult or impossible.

Another factor that comes into play is PCOS. The World Health Organization identifies PCOS as one of the most frequent causes of infertility across the world, although the exact mechanism by which it causes infertility requires more research to understand fully.

Seeking Expert Fertility Advice

Thankfully, with proper medical care, women with ovarian cysts can still have successful pregnancies. One can still ovulate with an ovarian cyst and conceive naturally. This depends on the size and location of the cyst. Some women may require medication to help regulate their ovulation or even begin ovulating altogether. If medication is unsuccessful, surgery may be an option for improving fertility. 

The chances of getting pregnant after ovarian cyst removal depend again on the size, location, and hormonal impact the cyst has on the individual’s body. If the impact is significant, it could take several months or longer for fertility to return. 

IVF with a cyst

In some cases, IVF can be done with the cyst present. However, to improve the chances of conception and successful pregnancy, the cyst may need to be removed before the procedure. This is especially so when the cyst is blocking the ovary from releasing an egg, which can prevent fertilization from occurring. 

Additionally, a cyst can make IVF more difficult by preventing the safe and successful removal of the eggs from the stimulated ovary during IVF treatment. 

Bottom line

Ovarian cysts are a common condition affecting women, and depending on the type, they can cause infertility. Nevertheless, with the right treatment, one can improve fertility and chances of conceiving. If you are hoping to get pregnant, it is wise to check if you have an ovarian cyst and seek help for the best course of action.