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Ovarian cysts are small, fluid-filled sacs that form on the ovary and are typically benign. They are a very common condition that affects persons assigned female at birth.

While most ovarian cysts resolve on their own, some forms of cysts can be harmful and require medical intervention.

Ovarian cysts rarely cause complications, but they can be an indication of serious disorders like endometriosis and polycystic ovarian syndrome. In this article, we shall be discussing all about ovarian cysts.

What Is an Ovarian Cyst?

Ovarian cysts are little sacs that form on the ovaries and are filled with fluid. They come in different sizes and fortunately, most do not pose a threat to fertility, as they go away on their own without causing any symptoms. 

Typically, they are discovered during routine pelvic examinations or ultrasounds. Sometimes, they can cause serious problems when they rapture or grow large enough to inhibit day-to-day living. 

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 they come with different symptoms and subsequent treatment. 

Functional Cysts

Functional ovarian cysts are the most common type of ovarian cysts. They appear 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. During ovulation, one follicle reaches full maturity and ruptures, releasing an egg. In some cases, the egg fails to release or the follicle continues to grow, forming a cyst. 

It is difficult to know whether you have a functional ovarian cyst without an ultrasound. This is because most functional ovarian cysts resolve themselves on their own.  

Functional cysts can be categorized into two:

• Follicular cysts which form when the follicle stays intact and continues to grow instead of releasing an egg.
• Corpus luteum cysts which sometimes form after ovulation once the egg has broken free and the follicle reseals itself and fluid builds up inside it. 

Non-Functional Cysts

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

Endometriomas

These are also known as “chocolate cysts”. They form when endometrial tissue forms outside of the uterus due to endometriosis. They are also indicative of other complications from the disease that might be present.

Although the specific link between endometriosis and fertility has not been fully understood, a 2010 study found that subjects with endometriosis were significantly more likely to experience infertility. While there is no cure for endometriosis, there are surgical and medication-based interventions that can address the symptoms, minimizing its impact.

Polycystic Ovarian Syndrome (PCOS) 

PCOS is a condition whereby a number of tiny cysts form on the ovaries. It affects around 20% of women in their reproductive years. While the cysts themselves may not necessarily have to be removed, the symptoms can have long term effects on an individual. Some of which 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 addresses 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 tumours 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 we have seen, most ovarian cysts do not present with any symptoms, and many people go about their lives unaware they have any cysts at all. Nevertheless, sometimes a cyst can grow too large or even rupture. 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

It is crucial to 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
• Heavy vaginal bleeding
• Feeling faint or dizzy

Treating Ovarian Cysts

In treating ovarian cysts, some options offered to patients include the following.

Monitoring

Many cysts are benign and asymptomatic, which means they do not require immediate treatment. 

When cysts are asymptomatic, healthcare professionals will recommend waiting a few months. Many times, the cyst will resolve on its own. They may also monitor cysts using ultrasound examinations to mitigate any potential issues in the future. 

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 as well as inhibit ovulation in order 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. Laparoscopic surgery - a non-invasive procedure - is one where the cysts are removed by making small incisions in the abdomen to give access to surgical tools as well as a thin, flexible tube with a camera on it. If the cysts are cancerous or too large, the more invasive open surgery may be the only option. 

Do Ovarian Cysts Cause Infertility?

Most ovarian cysts do not cause infertility on their own, but for people looking to conceive, being aware of the potential impact of ovarian cysts on fertility is essential. 

Additionally, the World Health Organization has identified PCOS as one of the leading causes of infertility globally. The exact mechanism by which it causes infertility however, still requires more research to fully understand.

Ovarian cysts could cause infertility by:

• Preventing 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.

Seeking Expert Fertility Advice

Thankfully, with proper medical care, women with ovarian cysts can still have successful pregnancies. Ovulation and conception are still possible with an ovarian cyst depending on the size and location of the cyst. Some people may require medication to help regulate their ovulation or even begin ovulating altogether. 

Surgery, where medication has been unsuccessful, may also be an option for improving fertility. It must be said that the chances of getting pregnant after ovarian cyst removal depend on the size, location, and hormonal impact the cyst has had on the individual’s body. If the impact is significant, it could take several months or longer for fertility to return to normal. 

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. Particularly in cases where the cyst is blocking the ovary from releasing an egg, which in turn can prevent fertilisation from occurring. 

A cyst can also make IVF more difficult by preventing the safe and successful removal of the eggs from the stimulated ovary. 

To Sum It Up

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

Having an ovarian cyst does not necessarily mean you will not be able to conceive. Even with an ovarian cyst that could potentially lead to fertility issues,  Nevada Fertility Center has a number of treatment options available to protect or enhance the likelihood of you becoming pregnant. Contact us for further assistance.