How to conceive with ovarian cysts?

Ovarian cysts are simply fluid filled sacs on or within the ovaries. Cysts can naturally happen because of an ovulation cycle. They are very common, and most women will experience a cyst at some point during their lives. But all ovarian cysts are not the same, while some are harmless they will either break or get re-absorbed, while others can affect the ability to get pregnant. Unless they become very large, these cysts generally don’t affect fertility. To understand conceiving with an ovarian cyst lets go through the article.

Chances of getting pregnant with an ovarian cyst

To get pregnant, one needs to have a good health, a healthy lifestyle, must eat a balanced diet. Several health conditions may upset the plans of having a baby by affecting fertility. One of such health condition may be the presence of ovarian cyst. Ovarian cyst can be associated with decreased fertility, but it depends on the type of an ovarian cyst.

How does an ovarian cyst form?

Each month the brain stimulates the ovary to make (an) egg by releasing a hormone that stimulates a follicle to grow. Follicle stimulating hormone (FSH) causes a fluid collection around an egg to enlarge. Once the egg is mature, a second hormone is released by the brain to get the ovary to release the egg. After the egg comes out (Ovulation), the follicular cyst converts to a cyst that has a yellow pigment called lutein. So, during each monthly cycle, there is a cyst normally present in the ovary.

For the first two weeks, the growing follicular cyst contains the maturing egg, and for the second two weeks, the corpus luteum makes a hormone to help promote a pregnancy. In rare cases, a fluid accumulates within a thin membrane inside the ovary, and there is no egg inside, and forms a cyst. If a cyst grows larger than 5 centimetres, one must have follow up check ups in a month or two to see if it will continue to grow. If it gets larger, then one might need surgery to remove the cyst. Even though these types of cysts always don’t have a negative effect on fertility.

Infertility due to cysts

In some cases when women are on birth control pills or hormone medications they will not be able to conceive. The contraceptive medication prevents ovulation and hence inhibits pregnancy. Oral contraceptive is 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 endometriomas can 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 cyst and do not go on their own. These cysts hamper fertility and prevent a woman from getting pregnant by causing a hormonal imbalance and restricting follicle maturation.

Types of an ovarian cyst (broadly divided according to fertility)

1) Cysts, which don’t affect fertility/pregnancy
2) Cysts, which interfere with fertility/pregnancy

1) Cysts which don’t interfere with fertility/pregnancy

These ovarian cysts, even though may cause pain and bleeding, will not affect one’s fertility unless their size increases significantly.

  • Functional ovarian cysts

    A functional cyst is either follicular or luteal cyst that develops on the surface of the ovary during menstrual cycle. They usually hold a developing egg. In a normal case, the sac becomes small and dissolves once the egg is released. This sac may swell up with fluid, if an egg is not released, or if the sac closes again after the egg is released. These cysts do not show any signs or symptoms. They usually dissolve without any treatment after couple of menstrual cycles. Functional cysts do not cause infertility, pregnancy can easily be achieved with a functional cyst.

    But if a cyst becomes too large, it can get ruptured and bleed, an ovarian torsion can happen that can cause extreme pain. Ovarian torsion happens in cases of enlarged ovaries. The incidence of ovarian torsion rises 5-6-fold during pregnancy. If not diagnosed in time it can cause foetal death and even potential loss of fertility of the woman. So, a large cyst should be monitored to avoid any fatal consequence. Ruptured cysts can cause pelvic infection which may scar the fallopian tubes and can affect getting pregnant.

  • Cystadenomas

    They are a kind of benign tumour. They are growths in the ovary that develop from the tissues at the surface of the ovary. Although they require treatment, cystadenomas do not affect fertility.

  • Dermoid cysts

    A strange type of tumour, generally harmless found in the ovary that typically contains different types of tissues, including neural tissue, hair, teeth, bone, instead of fluid. Dermoid cysts do not cause infertility.

2) Cysts which interfere with fertility/pregnancy

Two types of cysts that are most harmful to fertility are ovarian cysts resulting from polycystic ovary syndrome, and endometriomas – caused by endometriosis. These cysts need treatment because they may cause fertility issues.

  • Endometrioma

    They are also known as an endometrial cyst, it is a type of cyst formed when endometrial tissue, abnormally grows in the ovaries. The endometrium is the mucous membrane that lines the inner layer of the uterine wall. It affects pregnancy and causes chronic pain in the pelvic area during periods. Endometrial cysts are more often packed with dark, reddish-brown blood and may vary in size. They are also called chocolate cysts and causes infertility.

    Endometrioma-or-Chocolate-cyst-on-ovary
    Endometrioma or Chocolate cyst on ovary

    Endometriosis affects 5-10% of all women, and not all of them have fertility problems. A woman with endometrioma may not experience any issues or pain. It is only discovered during routine gynaecological examination through a vaginal ultrasound or X-ray. An endometrioma or chocolate cysts begin as a small lesion on the ovaries. It may remain very small (just a few millimetres in size) and is not a cause for concern. However, some cysts grow large (over 10 cm) or become very painful with the menstrual cycle.

    Larger cysts tend to be the most problematic for fertility. If an endometrioma ruptures, its contents can enter the pelvic cavity. This can cause ovaries to adhere to the fallopian tubes creating fertility blockages and pain. Endometriomas disturb the normal tubo-ovarian relationship. In severe cases, endometriomas can affect ovarian reserve, damage the ovaries, or even require oophorectomy (removal of the infected ovary, and keeping the other ovary intact) which makes a female infertile.

  • Cysts resulting from PCOS (Poly cystic ovarian syndrome)
  • Polycystic ovarian syndrome, or PCOS are most common cysts that create problems in a woman trying to get pregnant. They can cause enlarged ovaries and the development of small ovarian cysts due to hormonal imbalance. Many small cysts in ovaries along with irregular periods, excess hair growth, acne, insulin resistance and obesity are all symptoms of polycystic ovary syndrome. Hence conceiving with polycystic ovary syndrome becomes problematic by hampering fertility, causing a hormonal imbalance and restricting follicle maturation

    polycystic-ovary
    Polycystic Ovary

    Women with PCOS can struggle to become pregnant and are at higher risk of developing complications during pregnancy. However, by managing the symptoms, many women with PCOS can become pregnant and have a healthy baby. It is important for patients to visit a doctor if they experience any symptoms related to PCOS. This will reduce the risk of complications when a woman decides to become pregnant. PCOS women struggle to get pregnant because of the presence of high levels of the male hormone androgen which prevents the release of an egg (ovulation).

    While conceiving with a polycystic ovary, certain things need to be followed, such as a woman should maintain a healthy weight, healthy eating, exercise regularly, monitoring ovulation and plan sexual intercourse accordingly. A doctor might prescribe fertility medicines, if medications doesn’t work, doctor might suggest surgery to remove a tiny amount of tissue that produces excess male hormone in the ovaries. Otherwise complications during pregnancy might increase such as miscarriages, high blood pressure induced by the pregnancy, gestational diabetes and even premature birth.

How to Conceive with ovarian cysts?

So, from the above article we understand that women suffering from conditions like polycystic ovaries and endometriomas might face fertility issues. However, they can be managed with lifestyle changes or infertility treatments or a minor surgery (removal of endometrioma). But if medications or any other treatment doesn’t work, and the existing cyst has caused any kind of scarring, the last option that would be available for these women would be IVF (In vitro fertilisation), which would offer the best chance of conception. IVF is an assisted reproductive technology in which the ovaries are artificially stimulated by administering hormonal injections and when the eggs are mature they are extracted directly from the ovaries and fertilised in a lab and then embryo is transferred in a woman’s uterus.

Ovarian cyst success story

Tina (34) was trying to conceive for a long time, but each time a negative urine pregnancy test broke her heart.

I was diagnosed with polycystic ovarian syndrome at the age of 17. I always knew I would have trouble conceiving. After trying naturally when I couldn’t conceive I decided to visit a fertility clinic. After a lot of research and going by high success rate I decided to visit Medicover Fertility. There, I met Dr Sweta Gupta who is the Clinical director at Medicover. She recommended Ovulation induction therapy, a process that would increase the number of eggs ovulating each month. Dr Sweta Gupta also recommended me to see an Endocrinologist, where I was told to lose weight, a diet plan was charted out, and some medicines were given. I worked hard, but it didn’t help me with my fertility issue. I had even one unsuccessful IUI (Intra uterine insemination). After a failed IUI Dr Gupta recommended IVF. My first cycle of IVF was cancelled due to low egg production, my second cycle was successful as all other things were kept in mind. And thank you Medicover Fertility and Dr. Gupta I have beautiful twin boys today.

Doctor’s suggestion on ovarian cyst – Dr. Sweta Gupta (Clinical Director – Medicover Fertility)

PCOS treatment is often focused on reducing the symptoms of the disorder and maintaining a healthy lifestyle. Main focus should be on weight reduction. Drugs are given to induce egg formation in each menstrual cycle and when one mature egg forms, timed intercourse or intrauterine insemination is advised. Some PCOS patients are resistant and it is difficult to induce egg formation with oral drugs.

In these cases, to improve infertility PCOS IVF is considered by many healthcare professionals to be a great option. In ovulation induction which targets natural ovulation and conception, conception occurs naturally but it carries high risk of multiple pregnancies (more than 3 children). IVF is a targeted fertility treatment that limits the amount of embryo within the uterus, reducing the risk of multiple pregnancies.

How can Medicover Fertility help women with fertility issues caused by ovarian cyst?

Medicover Fertility is a fertility clinic that enables couples with severe infertility problems to successfully conceive and take home a healthy baby. Medicover uses advanced fertility treatments to help couples in dealing with different kinds of infertility complications. Infertility caused due to ovarian cysts can be successfully treated at Medicover.

Women who go through cyst removal (endometrioma) procedure which is minimally invasive, might face risk of getting a scar tissue, which worsens the cyst or damages healthy ovarian tissue. Women with PCOS might face severe problem with conceiving due to their hormonal imbalance, where medications, lifestyle management is not helping to solve infertility. For these women IVF (In vitro fertilisation) is the safest option available to conceive.

Here in Medicover, with its international standards, state of the art facilities and with latest technology provides patients with individualistic care. There is a team of highly experienced and internationally certified in-house doctors who help patients dealing with different types of fertility problems.

RELATED QUESTIONS

Q) I have functional cysts will it cause difficulty in conceiving?

A) Functional cyst forms during a normal menstrual cycle and generally do not cause or contribute to infertility.

Q) Can you ovulate with an ovarian cyst?

A) Ovulation problems accounts for about 25% of all cases of female infertility, and cysts like the polycystic ovary is associated with irregular ovulation.

Q) Can you get pregnant with cyst on ovary?

A) An ovarian cyst does not usually affect a woman’s ability to conceive but the only condition in which a cyst is linked with difficulty in getting pregnant is polycystic ovary syndrome.

Q) Can a cyst stop you from getting pregnant?

A) Some cysts affect pregnancy like the endometriomas and polycystic ovaries.

Q) Pregnancy after ovarian cyst surgery?

A) Pregnancy after an ovarian cyst removal should not be a problem. The cyst is very carefully removed laparoscopically, so that ovary can function and participate fully in the work of the reproductive system of the female. A full recovery of 3 months is needed after the surgery before trying to conceive.

Q) Do ovarian cyst causes infertility?

A) Depends on the type of cyst. Infertility is usually diagnosed after a couple has been unable to get pregnant after a 12- month period. Ovarian cysts that contain endometriomas and polycystic ovaries may be associated with infertility.

Q) Will paraovarian cyst affect pregnancy?

A) If a woman is trying to conceive and has a paraovarian cyst, and it is big enough, a doctor might recommend getting it removed laparoscopically as it might be difficult to conceive with a paraovarian cyst, and these cysts do not get affected by birth control pills.

Q) Will ovarian torsion affect pregnancy?

A) Women who are treated with fertility drugs develop ovarian hyperstimulation syndrome and are at higher risk of ovarian torsion during pregnancy than those who do not become pregnant. Ovarian torsion during pregnancy can cause extreme pain, it should be removed, otherwise can cause haemorrhage or necrosis.

(*necrosis – Death of most or all of the cells in an organ or tissue, due to failure of blood supply)

Q) I have dermoid cyst. Will it affect my pregnancy?

A) The course of pregnancy of patients with dermoid cysts is favourable. The cysts should be managed conservatively if possible with routine ultrasound follow up during pregnancy since complications are extremely rare.

Q) Tissues from one of my ovary is removed due to cyst. Can I still get pregnant?

A) If the other ovary is intact and if there is no problem in ovulating then a woman should not have any problem in conceiving.

Q) What are the chances of a successful IUI with a cyst?

A) When a couple is recommended with IUI treatment, it is advisable not do it in the presence of a simple cyst because during ovulation induction, it will be difficult to differentiate between an actual growing follicle and the clear cyst. So, a cyst might be misdiagnosed as follicle and exact timing of IUI might go wrong.


References
1) https://www.todaysparent.com/getting-pregnant/trying-to-conceive/fertility-myths-that-are-hurting-your-chances-of-getting-pregnant/
2) https://www.mayoclinic.org/diseases-conditions/ovarian-cysts/expert-answers/ovarian-cysts-and-infertility/faq-20057806
3) https://www.beingtheparent.com/ovarian-cysts-affect-pregnancy/
4) https://www.romper.com/p/how-do-you-get-pregnant-if-you-have-ovarian-cyst-expert-explains-71880
5) http://natural-fertility-info.com/chocolate-cysts.html
6) https://www.pregnancybirthbaby.org.au/pcos-and-pregnancy
7) http://www.ivflite.org/article.asp?issn=2348-2907;year=2015;volume=2;issue=3;spage=99;epage=101;aulast=Shah
8) https://trmbaby.com/library/conditions/ovarian-cysts/
9) https://www.ncbi.nlm.nih.gov/pubmed/19554342
10) https://www.steadyhealth.com/topics/dermoid-cyst-and-pregnancy

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