Can Ovarian Cysts Cause Infertility?

Ovarian cysts are fluid-filled sacs that form on the ovary. They are very common to females, and though they usually resolve on their own, some types of cysts can be harmful, requiring medical intervention.

Ovarian cysts rarely cause complications, but they can indicate the presence of disorders like endometriosis and polycystic ovarian syndrome. Let us discuss further about ovarian cysts.

What Is an Ovarian Cyst?

Ovarian cysts are different sized sacs filled with fluid that form on the ovaries. Usually, they do not negatively impact a person’s fertility, and often go away without causing any symptoms. Sometimes, however, they can rapture or grow large enough to inhibit day-to-day living. 

Types of Ovarian Cysts

Cysts typically fall into two main categories - functional and non-functional cysts. Each presents with different symptoms, requiring different courses of treatment. 

Functional Cysts

These are the most common type and form when an ovary either fails to release an egg, or when the follicle within which an egg matures continues growing after releasing the egg within.

Since most functional ovarian cysts resolve on their own, it is not easy to tell whether you have one without an ultrasound. Functional cysts are categorized in two:

• Follicular cysts - They form when the follicle stays intact and continues to grow instead of releasing an egg.
• Corpus luteum cysts  - They form when, after the egg has broken free, the follicle reseals itself and fluid builds up within it. 

Non-Functional Cysts

Non-functional ovarian cysts are also categorised into two: those that are benign or those that indicate a more serious issue. Non-functional ovarian cysts include: 

Endometriomas

Known as “chocolate cysts” for their dark brown coloring, they form when the endometrial tissue, typically found within the uterus, forms outside of the uterus due to endometriosis. They could also point to other complications from the disease that might be present.

The link between endometriosis and fertility has not been fully understood, but a 2010 study found that people with endometriosis had higher risks for infertility. There are surgical and medication-based treatments that help to manage the symptoms, but there is still no cure for endometriosis.

Polycystic Ovarian Syndrome (PCOS) 

PCOS affects about 20 percent of females in their reproductive years. Several tiny cysts form on the ovaries, and though they may not need to be removed, accompanying symptoms such as weight gain, acne, excessive hair growth, baldness, extreme tiredness, and difficulties conceiving can cause long term effects. PCOS has no cure but it can be managed with medication-based therapy.

Cystadenomas 

These are small benign tumours that are typically filled with a clear, mucus-like liquid. They usually do not present any symptoms, and can be surgically removed if complications arise. According to the National Institute of Health, ovarian cystadenomas rarely cause complications and are quite common. 

Symptoms of Ovarian Cysts

Many people go about their lives unaware they have any cysts at all because most ovarian cysts do not present with any symptoms. That being said, at times a cyst can grow too big or rupture. Below are some symptoms of a large or ruptured cyst:

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

Seek immediate emergency medical attention if the pain is accompanied by:

• Feeling faint or dizzy
• Severe nausea and vomiting - which could be a sign of an ovarian torsionFever - which could be a sign of infection
• Heavy vaginal bleeding

Treating Ovarian Cysts

Some options available in the treatment of ovarian cysts are outlined below:

Monitoring

Because many cysts are benign and asymptomatic, they do not require immediate treatment. 

When this is the case, healthcare professionals recommend waiting for a few months and often, the cyst resolves on its own. Cysts may also be monitored using ultrasound examinations to mitigate any future potential issues. 

Hormonal Treatments

Hormonal treatments are commonly used as preventive measures. Typically, oral contraceptives or gonadotropin-releasing hormone agonists (GnRH) are prescribed. These help to regulate the menstrual cycle and inhibit ovulation so that cysts do not form in the first place. 

Surgery

When cysts become large or complex, surgical intervention may be the only solution. Laparoscopic surgery is non-invasive. Cysts are removed by making small incisions in the abdomen to give access to surgical tools and a thin flexible tube having a camera on it. When cysts are found to be cancerous or too large, an open surgery may be the only option. 

Do Ovarian Cysts Cause Infertility?

Most ovarian cysts do not cause infertility on their own, but the World Health Organization identified PCOS to be a leading cause of infertility globally. Therefore those hoping to have children need to be aware of the potential impact ovarian cysts can have on their prospects.

Ovarian cysts could potentially cause infertility by:

• Preventing ovulation
• Causing pain and discomfort, making intercourse difficult or impossible.
• Creating hormonal imbalances that can affect ovulation. 

Seeking Expert Fertility Advice

Proper medical care can help women with ovarian cysts to have successful pregnancies. Depending on the size and location of the cyst, ovulation and conception are still possible. Some people may require medication to  regulate ovulation or cause ovulation altogether. 

Where medication has not succeeded, surgery may improve fertility. The likelihood of getting pregnant after ovarian cyst removal largely depends on the size of the cyst, its location, and any hormonal effects it may have had. If these factors are significant, it could take several months or longer for fertility to normalize. 

IVF With a Cyst

It could be possible to undergo IVF with a cyst present, but removing it beforehand greatly improves the chances of success, especially if the cyst is blocking the ovary from releasing an egg. Besides, a cyst could make egg retrieval from the stimulated ovary challenging. 

To Sum It Up

Ovarian cysts are common, but depending on the type, they could also cause infertility. With the right treatment however, fertility and the likelihood of conception can be greatly improved. If you are planning to start a family, consult with a healthcare professional to check if you have an ovarian cyst, as well as determine the best course of action if you do. 

Ovarian cysts do not necessarily prevent conception. Should an ovarian cyst potentially lead to fertility issues,  Nevada Center For Reproductive Medicine has various treatment options to protect or enhance your chances of becoming pregnant. Contact us for more information.