Conceiving with ovarian cyst

Want to have a baby but not able to? This is the heart cry of thousands of couples who are desperately trying to conceive. The inability to get pregnant is prevalent in one out of every 5 young couples. These figures can sound very alarming, but it is also reassuring for others to know that they are not alone. The problem is a common one. Infertility is a growing concern and understanding exactly what it entails is becoming increasingly necessary.

One needs to understand why a woman is not able to get pregnant and how conception works. We will take a quick overview of the female reproductive organs. You need to have a basic understanding of the role each organ plays in the process of pregnancy, and how its malfunction is hindering you from conceiving. You also need to understand what the different ways around this are and how you can conceive irrespective of any problems that you may have with your reproductive organs.

Understanding how fertilisation takes place

The woman does the major work in making a baby while the male partner’s role is limited to contributing a sperm. No doubt, without a sperm conception is not possible. The female reproduction starts with the ovaries. Every woman has two ovaries. These ovaries are filled with follicles and each follicle houses an immature oocyte (egg). The female egg when it fuses with the male sperm forms an embryo. This embryo grows into a baby in the uterus, also known as the womb.

When a girl enters puberty her fertility stage begins and she starts her menstrual cycle. Many young girls find their menstrual cycle a hindrance to their life and freedom as they knew it, but as time goes by they understand the importance and significance of a regular menstrual cycle and keeping track

A typical menstrual cycle is 28 days. During every cycle a follicle stimulating hormone (FSH) is released by the pituitary gland and this encourages about 5 follicles to mature the eggs they contain. One dominant oocyte matures fully while the others disintegrate. Upon maturation the dominant mature oocyte moves into the fallopian tube. The fallopian tube is where the sperm meets the oocyte to fertilise it. The oocyte remains in the fallopian tube for a duration between 12 to 24 hours. This is known as the fertility window. If the oocyte is not fertilised during this time period it moves further towards the uterus and disintegrates. For pregnancy to take place it is essential for the sperm to reach the fallopian tube in time to meet the oocyte before it moves on and is gone.

A woman is born with her storehouse of eggs for a lifetime. Her ovaries contain around 2 million immature eggs at birth. The number of oocyte a woman has at birth is what she will use for her lifetime. Her body will not produce any new eggs. With each menstrual cycle a few oocyte are used up. Once all the follicles in the ovaries are exhausted a woman enters menopause. For a woman menopause marks the end of her fertility cycle. The general age for menopause is around 60.

Even though a woman has two ovaries and they both contain follicles, on a particular cycle only one ovary will mature the oocyte. The following cycle the next ovary will mature the oocyte. Therefore during every cycle only one fallopian tube will contain an egg. The fallopian tubes are very fine and delicate structures which connect the ovaries to the uterus. The fallopian tube houses the mature oocyte for a short while and this is where fertilisation takes place. Once an embryo is formed after the oocyte fertilisation it remains in the fallopian tube for another 72 hours then proceeds towards the uterus.

In anticipation of the oocyte being fertilised the uterus also begins to prepare itself to receive the embryo. The inner lining of the uterus known as the endometrial lining begins to thicken. The endometrial lining has to be of a certain minimum thickness to be regarded as receptive to the embryo. When the embryo comes into the uterus it attaches itself to the endometrium in a process known as implantation. In the event that fertilisation does not take place and there is no embryo to implant, the endometrial lining is shed and a few days later a woman has her menstrual cycle.

Ovarian cyst

The ovaries play a very vital role in reproduction cycle. The ovary houses the most important element, the oocyte, without which a pregnancy cannot take place. A cyst is a fluid filled sac. Every woman has cysts in her ovaries at some point or the other, but they are usually painless and do not have any symptoms. These cysts normally disappear by themselves and you may not even be aware you had them.

Cysts become problematic when they don’t go away but instead grow bigger and start causing you pain. The common symptoms of cysts in the ovaries are:

  • Pain in the pelvic area
  • Abdominal bloating
  • Nausea and vomiting
  • Pain during intercourse
  • Painful bowel movements

These are some of the general symptoms that accompany the presence of cysts in the ovaries. If you have more severe symptoms like fever, shortness of breath, dizziness or sharp and very severe pain in the pelvic region you should get medical attention immediately. These symptoms could mean a ruptured cyst or even an ovarian torsion.

Diagnosing cysts

The presence of cysts can be diagnosed by the doctor during a routine pelvic exam. Since women regularly develop cysts during their menstrual cycle and even while pregnant, cysts are not given much importance when detected during a routine examination. In the event that the cyst is painful or seems enlarged the doctor may recommend some tests to get a better idea about the shape and size of the cyst as well as the location. The doctor is also able to determine the composition of the cyst whether it is solid or filled with fluid.

Some of the recommended tests for detecting cysts are:

  • Ultrasound: In this test high frequency sound waves are used to produce an image of the ovaries. If there are cysts present in the ovaries the doctors can see the shape and size in the ultrasound image.
  • CT Scan:The CT scan gives a cross-sectional image of the of the ovaries for the doctor to view the cysts and their location
  • MRI: The magnetic fields used for the MRI testing gives an in-depth view of the ovaries and the cysts that may be present in it.

Many cysts are temporary and go away on their own. Due to this reason the doctor may not immediately prescribe some treatment when they find cysts. Instead they may prefer to wait for a few months to check if the cysts are still in the ovaries or have disappeared.

Types of cysts

There are many types of cysts, but the most common ovarian cyst is the functional cyst. There are two types of functional cysts:

Follicular cysts: Some of the follicles that mature during the fertility cycle do not rupture to release the egg, instead they continue to grow and result in the formation of cysts.

Corpus luteum cysts: When the egg is released from the follicle the follicle usually dissolves. In some cases the follicle does not dissolve but instead closes up again and fluid forms inside it.

Both the follicular cysts and the Corpus luteum cysts are harmless and disappear on their own after a few months. Doctors usually do not pay much heed to these types of cysts as they will take care of themselves.
Other types of cysts are quite uncommon and occur very rarely. These are:

Dermoid cysts: These cysts look like sacs and are made up of tissue that is similar to that of hair, teeth, fat, skin and other such tissue. They are formed from embryonic cells which account for their strange composition. Dermoid cysts are also called teratomas.

Cystadenomas: These cysts are non-cancerous and grow on the outer surface of the ovary. They are usually filled with mucus like material which is watery.

Endometriomas: The endometrial lining of the uterus sometimes grows on the outside of the uterus in a condition called endometriosis. When this tissue grows onto the surface of the ovary it forms cysts.

While functional cysts are more common, some women may suffer from other cysts as well. Doctors can diagnose the type of cyst through the tests and determine if it needs to be treated or will go away on its own. Functional cysts do not need treatment but other cysts need some medical attention.

Complications of ovarian cysts

The dermoid cysts and the cystadenomas could cause a problem if they get enlarged. It can cause ovarian torsion. In this condition the ovary gets twisted causing the blood flow to the ovary to get disrupted. Ovarian torsion is a dangerous situation as it could lead to further problems like death of the ovary. A dead ovary will no longer function and may as well not be present the body at all.

In a few cases the cysts continue to grow and rupture. This causes internal bleeding, excessive pain and can also lead to an infection. If a ruptured cyst is left untreated it can even be fatal.

Most ovarian cysts are benign and disappear. In some cases the cyst may be cancerous. In some women doctors have found cancerous cystic masses in the ovaries. These are removed by removing a part of the ovary or in some cases the whole ovary.

Treatment for ovarian cysts

Treatment is prescribed for patients in whose case the cysts could cause a problem. In most cases the doctors wait for several months in case the cysts disappear on their own accord. If the patient is suffering from severe pain and other symptoms the doctors may consider immediate treatment.

Some of the treatment options for ovarian cysts are:

Birth control pills: Some women have recurrent ovarian cysts. They keep getting cysts regularly. In this case the doctors prefer to prescribe birth control pills. The oral contraceptives will stop ovulation and which will prevent new cysts from forming. However this medication will not heal or reduce the existing cysts. Birth control pills are given when women are continuously getting cysts with each ovulation cycle and the number of cysts in the ovaries is increasing with each menstrual cycle. By temporarily stopping ovulation it gives these existing cysts time to go away and clear the ovary of any cysts. Birth control pills are also recommended for prevention of ovarian cancer caused through cysts. Once women have crossed menopause they are at a higher risk of ovarian cancer cause by the cysts.

Laparoscopy: If the cysts are small and are not disappearing by themselves over several months, they can be removed through a laparoscopic procedure. This is a minimally invasive surgical procedure in which a small incision is made in the abdominal area enabling the doctor to insert an instrument with a camera to remove the cysts.

Laparotomy: Cysts that are continually growing and show no signs of disappearing over 3 or 4 months need to be removed surgically. The Laparotomy is a surgical procedure in which an incision is made in the abdomen to remove the cysts. This procedure also involves checking to see if the cyst is cancerous by conducting an immediate biopsy. If the cyst is found to be cancerous the doctors may remove the whole ovary and in some cases the uterus as well if the cancer has spread.

Ovarian cysts that are not cancerous, but continuously growing need to be removed as they could burst or lead to ovarian torsion. If one ovary is badly affected by cysts the doctors may decide to remove it. However if only part if the ovary is affected they may clear out that part of the ovary leaving the rest intact. Removal of the ovary is only considered in cases where there could be a risk of cancer.

Risk factors of ovarian cysts

Are you wondering how a woman gets cysts and what you can do to prevent it? There is nothing in particular that you can do to prevent yourself from getting the cysts; it is a part of the natural cycle. Every woman gets functional cysts and they don’t even realise it, but it causes no damage and is gone in a short while. The other types of cysts are less common and very few women get them. However, there are some factors that put you at higher risk for getting these non-functional cysts. Some high risk conditions are:

  • Hormonal problems: If you suffer from a hormonal imbalance the probability of getting ovarian cysts is much higher. Some fertility drugs like clomiphene which is used to induce ovulation may cause ovarian cysts.
  • Pregnancy: When you are pregnant the cysts that form during ovulation tend to remain all through your pregnancy.
  • Endometriosis: This is a condition where the endometrial limning grows outside the uterus. Usually on other surrounding organs like the ovaries. The growth on the outer surface of the ovaries causes cysts to form.
  • Pelvic infection: A pelvic infection can cause much damage to the reproductive organs of a woman. If the infection affects the ovaries it can cause cysts to appear within the ovaries.
  • Previous cysts: If the patient has a history of previous cysts in the ovaries, then the likelihood of cyst formation again is quite high, even if the previous cysts have been surgically removed.

It is advisable to be cautious if you are susceptible to cysts as this could affect your health in a number of ways.

Infertility due to cysts

In some cases when women are on birth control pills or hormone medication they will not be able to conceive. The contraceptive medication prevents ovulation and the hence inhibits pregnancy. Oral contraceptives are prescribed to those women who are currently not considering family planning.

Some cysts like functional cysts, dermoid and cystadenomas do not affect the fertility of a woman or the normal functioning of the ovaries. Cysts like endometriomascan cause infertility and prevent a woman from being able to conceive naturally. Women whose ovaries continue to make lots of small cysts are known to have a condition called polycystic ovaries. These are non-functional cysts and do not go away on their own. These cysts hamper fertility and prevent a woman from getting pregnant by causing a hormonal imbalance and restricting follicle maturation.

Polycystic ovaries is a common condition among a growing number of young women. Women need to be more conscious about changes in their body such as pelvic pain, irregularities in their menstrual cycle, sudden weight loss, bloated feeling and loss of appetite. These could be symptoms that something is wrong and you should get medical attention to have it corrected before things get out of hand.

Conceiving with ovarian cyst

Women with conditions such as polycystic ovaries and endometriomas are infertile and cannot conceive naturally as their ovaries are not working properly and they are most probably not ovulating either.Women who have cysts in their ovaries also suffer from an ovulation disorder which prevents the ovaries from releasing a mature egg for fertilisation by the sperm.

Fertility treatment option
The only option for these infertile women is In Vitro Fertilisation (IVF). This is a procedure in which the ovaries are artificially stimulated by administering hormone injections and when the eggs are mature they are extracted directly from the ovaries fertilised in a lab and then placed back in the uterus.

Fertility help at Medicover

Medicover Fertility Clinic is an IVF centre that enables couples with severs infertility problems to successfully conceive and have a baby. Medicover uses advanced fertility treatments to helps couples with different kinds of infertility complication. Infertility due to ovarian cysts can be successfully treated at Medicover.

The international standard IVF clinic offers patients state of the art facilities and the latest technique fertility treatment. Medicover also believes in giving their patients individualised care. The team of high experienced and internationally certified in-house doctors help patients with all types of infertility problems.

Some FAQ’s

Q: I have functional cysts and I am unable to get pregnant.
A: You may have some other complication which is preventing you from getting pregnant other than the cysts.

Q: I have dermoid cysts and my doctor refused to operate to remove them. I am scared that it could induce premature menopause.
A: Cysts are not known to induce premature menopause. If you are not satisfied with your doctor’s judgement about your cysts, get a second opinion. Only after seeing the test results can a doctor give a proper diagnosis and decide if the cysts need to be removed.

Q: Part of my one ovary was removed due to cysts. Can I still get pregnant?
A: If you are ovulating you can get pregnant. With part of an ovary and one whole ovary you should not have any problem conceiving.

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