Can Ovarian Cysts Cause Infertility?

The journey towards pregnancy can be a difficult one for some. Different factors can affect a woman’s fertility, including ovarian cysts.  Ovarian cysts are common among women, affecting around 10% of women. 

If you’re trying to conceive, you may be wondering if ovarian cysts can affect your ability to conceive. Is this the case? Let’s take an in-depth view of ovarian cysts.

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.

Understanding Ovaries

Before we look at ovarian cysts, it's important to understand how the ovaries work. Ovaries are a part of the female reproductive system and the endocrine system. Ovaries are almond in size and tend to mature during puberty. They are held in place by ligaments joined to the uterine wall and are connected to the uterus via fallopian tubes.

Ovaries perform:

• Hormone secretion
• Protection of the eggs 
• Facilitate ovulation (egg release)

What Are Ovarian Cysts?

Ovarian cysts are fluid-filled sacs that develop inside or, sometimes, on the ovaries. The cysts tend to be small and will most likely resolve on their own. This means that you can continue with your life without knowing you have the cysts. However, some women get the worst of it, and the cysts grow large and rapture. 

They are common among women of reproductive age and can be triggered by different factors, including menstruation or pregnancy. They can also be a symptom of a larger underlying health condition such as endometriosis and can cause pain, discomfort, or even rupture. 

Types of Ovarian Cysts

Ovarian cysts present as:

• Functional cysts: These are the most common cysts and can be a result of the menstrual cycle. They are rarely a cause of concern and usually resolve on their own. 
• Non-functional cysts: These cysts can either be benign or can indicate more serious issues.

Follicular Cysts 

Follicular cysts are the most common functional cysts. The cyst forms on the ovary due to incomplete rupture and reabsorption during ovulation. The menstrual cycle has two phases: the follicular phase and the luteal phase. 

During a menstrual cycle, a follicle grows in the ovary, and ovulation stimulates the rupture of this follicle and the release of an egg. However, in some cases, the follicle doesn’t rupture, and the fluid inside the follicle forms a cyst. Many follicular cysts are asymptomatic, but some come with pelvic pain. 

Follicular cysts tend to have no symptoms, are usually small, and can go undetected until they spontaneously resolve. But sometimes, they can grow and show symptoms. These symptoms include:

• Pelvic pain
• Pain with sexual intercourse (dyspareunia)
• Uterine bleeding from hormonal irregularities
• Ovarian cyst rupture
• Hemorrhage
• Ovarian torsion ( twisting of the ovary around its support structures) 

Depending on their size, follicular cysts may be diagnosed through a physical exam (palpation of the ovaries) or an ultrasound. 

Corpus Luteum Cysts 

Corpus luteum cysts are also functional cysts. They are fluid-filled masses that grow on your corpus luteum. The corpus luteum is a group of cells that take shape after your ovary releases an egg and produces a hormone called progesterone that your uterus needs to grow a baby. The corpus luteum breaks down when it’s no longer needed, but it sometimes continues to grow, forming a cyst.  

Like follicular cysts, they are usually painless, so most people don’t even know they have one until it shows up as part of routine imaging, mainly during pregnancy. As long as you get your period, you can develop a corpus luteum cyst. Unless something goes wrong, it shouldn’t have any negative effects. It can only show symptoms once it ruptures. 

Cystadenomas 

An ovarian cystadenoma is a common type of non-functional cyst that rarely comes with symptoms or complications. It is a small and benign tumor filled with a clear, mucus-like liquid. The two main types are serous and mucinous cystadenomas. 

Symptoms can include abdominal pain, discomfort, and bloating. However, most patients are asymptomatic. If they need to be removed, they can be easily removed through surgery. 

Endometriomas

Endometriomas or “chocolate cysts” are ovarian cysts that form when tissue from the lining of the uterus grows in the ovaries. They are a symptom of endometriosis and contain dark brown menstrual blood, hence the name chocolate cysts.

The cause of endometriomas is unknown, but some may form as a result of retrograde menstruation. Retrograde menstruation happens when menstrual blood flows back into the body during a period instead of out through the vagina. Endometrial cells are carried backward with the menstrual blood through the fallopian tubes to the ovaries, where they implant and cause endometriosis.

According to a 2010 study, women suffering from endometriosis are significantly more likely to experience infertility. Even though 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, and it is associated with the development of multiple follicular cysts. 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.

Do Ovarian Cysts Cause Infertility?

Most ovarian cysts are asymptomatic and do not cause infertility on their own. Nevertheless, they have the potential to impact fertility negatively. Ovarian cysts can cause infertility by:

• Causing hormonal imbalances that can affect ovulation. 
• Causing blockage and preventing the ovary from releasing an egg.
• Causing pain and discomfort that can make intercourse difficult or impossible.
• Conditions like PCOS and endometriosis can cause cysts that result in infertility. 

If you’re trying to get pregnant and have an ovarian cyst(s), talk to a fertility clinic like NOVA IVF. The compassionate healthcare professionals at the clinic will offer you several treatment options available that can promote pregnancy. 

Treating Ovarian Cysts

Treatment of ovarian cysts depends on the type of cysts you have. In most cases, the doctor will monitor the cysts. This is because most cysts are benign and asymptomatic and don’t require immediate treatment. Monitoring can be done using ultrasounds, and the doctor will recommend waiting a few months to see if the cyst will resolve on its own. 

In other cases, a doctor will prescribe hormonal treatments like oral contraceptives or gonadotropin-releasing hormone agonists (GnRH) as preventive measures. These drugs are given to prevent the growth of cysts by regulating the menstrual cycle and preventing ovulation. 

If the cysts are large and have the potential to rupture, the only solution may be surgery. This is usually an invasive surgery called a laparoscopy. Here, small incisions are made in the abdomen, and a thin, flexible tube with a camera is inserted to remove the cysts. 

It is important to understand that any surgery on the ovaries can remove or damage healthy ovarian tissue and eggs or cause scar tissue, and this may lead to infertility. 

Bottom Line

Ovarian cysts typically affect mostly women of childbearing age because the menstrual cycle and its hormonal changes can trigger them. While Ovarian cysts are a common condition that can cause infertility, proper treatment and management can improve fertility and increase your chances of getting pregnant. In some cases, cyst removal may be presented as a treatment option if the cyst is large or looks like it can rupture.