Can Ovarian Cysts Cause Infertility?

An ovary is a small, oval-shaped gland found on either side of your uterus that stores your eggs and releases them during ovulation. Not only that, but they produce reproductive hormones that control your menstrual cycle. Your ovaries continue to release an egg each menstrual cycle until you reach menopause. Clearly, the ovaries play a pivotal role in your menstrual cycle. 

However, in many cases, the ovaries grow cysts that can cause challenges with fertility. In this article, we shall take a comprehensive look at ovarian cysts, what causes them, their symptoms, how to treat them, and how they affect fertility. 

Key Takeaways

• The ovaries play a key role in a female’s reproductive health
• Ovarian cysts can grow naturally
• Ovarian cysts are fluid-filled sacs found on the ovary
• These cysts are usually benign.
• Most ovarian cysts resolve naturally but others require medical intervention.

What Is an Ovarian Cyst?

An ovarian cyst is a fluid-filled sac found inside or on the ovaries that comes in different sizes. They are pretty common among women and many women develop the cysts at some point in their lives. Most cysts are benign and harmless and don’t have any symptoms or pain. This is why most women can go all their lives without knowing they have a cyst. 

Ovarian cysts can also disappear over time without the need for medical intervention. But, some can grow or rapture, causing disruptions in an individual’s day-to-day and fertility.

Types of Ovarian Cysts

Ovarian cysts are only visible during routine pelvic examinations or ultrasounds. During a check-up, your doctor will look out for two main types of ovarian cysts: 

Functional Cysts

These are the most popular cysts and usually appear during menstruation. Functional cysts develop because of slight changes in the way the ovary makes or releases an egg. The cyst may form when a sac on the ovary fails to release an egg. This sac then swells with fluid and may release the egg, seal up again but now with fluid inside. 

When the follicle stays the same but the cyst grows instead of releasing an egg, the functional cyst is called a follicular cyst. When a follicle shrinks into the corpus luteum after ovulation, luteal cysts can grow on the corpus luteum if the follicle reseals itself and fluid builds up inside.  

In most cases, only an ultrasound can reveal a functional cyst mainly because most functional ovarian cysts resolve themselves on their own.  

Non-Functional

Non-functional ovarian cysts are growths that don’t go away by themselves and can cause infertility. Functional ovarian cysts include: 

Endometriomas (Chocolate Cysts)

Endometriomas are cysts that form when the endometrial tissue grows outside the uterus. They are usually a sign of endometriosis and signal other complications may be arising. Studies have shown that women with endometriosis are more likely to experience infertility. There is no cure for endometriosis and in most cases, surgical and medical interventions are the best way to manage the symptoms and minimize its impacts.

Dermoid Cysts

Dermoid cysts or cystic teratomas are sac-like cysts with hair, fat, teeth, bone, and other tissue. Unlike other ovarian cysts, dermoid cysts don’t form because of your menstrual cycle. Instead, these cysts form when fully developed tissue collects in the ovaries. Dermoid cysts can develop from germ cells because they can mature into any type of tissue.  These cells can become overstimulated in women during their reproductive years.

Polycystic Ovarian Syndrome (PCOS) 

PCOS is a condition where several tiny cysts form on the ovaries and though they may not need to be removed, they can significantly affect a woman’s day-to-day as they cause excessive hair growth, baldness, weight gain, extreme tiredness, and difficulties conceiving. Around 20% of women suffer from PCOS and though it doesn’t have any cure, its symptoms are manageable. 

Cystadenomas 

Cystadenomas are ovarian cysts that contain a clear, mucus-like fluid. The National Institute of Health states that these cysts are common, rarely cause complications, and can be easily removed through surgery if complications arise. 

Symptoms of Ovarian Cysts

Many ovarian cysts are asymptomatic meaning they don’t show any symptoms and you can live with them without knowing. However, these cysts can sometimes grow too much or rupture. When a cyst is too big or ruptures, symptoms can be: 

• A sudden, sharp pain in the lower belly or back
• Consistent abdominal bloating
• Vaginal spotting or bleeding or sometimes heavy vaginal bleeding
• Menstrual irregularities
• Fever which could be a sign of infection
• Severe nausea and vomiting, which could be a sign of an ovarian torsion
• Faintness or dizziness

How Are Ovarian Cysts Treated?

Because ovarian cysts can go without being noticed, especially in premenopausal women. As such, they resolve on their own and rarely require treatment. 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. 

For premenopausal and menopausal women the cyst can grow, change appearance, or rapture. In such cases, the cysts have to be surgically removed. If the cyst is small and appears non-cancerous it is removed laparoscopically through several small incisions near the navel. If it’s too large or appears cancerous, it may require an open incision through the abdomen, and depending on what the doctor finds, the ovary may need removing.

Even with one ovary, one can still conceive. A fertility clinic like Ivy Fertility will use assisted reproductive technologies like in vitro fertilization or IVF which can increase the chances of conception and pregnancy compared to natural conception with just one ovary.  

Do Ovarian Cysts Cause Infertility?

While most ovarian cysts do not cause infertility on their own, it’s important to know that some can affect fertility by:

• Causing blockages that prevent the ovary from releasing an egg. 
• Creating hormonal imbalances that can affect ovulation. 
• Causing pain and discomfort, which can make intercourse difficult or impossible.

With proper medical care, women with ovarian cysts can still have successful pregnancies, especially if it doesn’t cause any blockages. This highly depends on the size, location, and hormonal impact of the cysts. 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. 

IVF can be done with the cyst present but to improve the chances of conception and successful pregnancy, the cyst may need to be removed before the procedure. This is because the cysts 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 affect many women and can be lived with when asymptomatic. However, depending on the type, location, and size, they can cause infertility. If you learn that you have an ovarian cyst and you're concerned about becoming pregnant, talk with your healthcare professional, who will be able to offer you treatment options that can boost your chances of pregnancy. Nevertheless, with the right treatment, one can improve fertility and chances of conceiving.