Can Ovarian Cysts Cause Infertility?

Ovarian cysts typically affect mostly women of childbearing age because the menstrual cycle and its hormonal changes can trigger them. This can make achieving pregnancy challenging for some women.  Ovarian cysts are common among women, affecting around 10% of women and different factors can affect a woman’s fertility, including 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.

What is an Ovarian Cyst?

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 in the following ways. 

Functional Cysts

Functional cysts affect more women and can be a result of the menstrual cycle. They are rarely a cause of concern and usually resolve on their own. 

Follicular cysts 

Follicular cysts are the most common functional cysts and they form on the ovary due to incomplete rupture and reabsorption during ovulation. 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 such as:

• 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) 
  

Corpus luteum cysts 

Another functional cyst, corpus luteum cysts, forms from the corpus luteum, a structure that produces progesterone after ovulation. Progesterone is needed for the uterus to sustain a pregnancy. The corpus luteum breaks down when it’s no longer needed, but it sometimes continues to grow, forming a cyst.  

Corpus luteum cysts are usually painless and as long as you get your period, you can develop a corpus luteum cyst. Most people don’t even know they have one. Unless something goes wrong, like the cyst raptures, there shouldn’t be any negative effects. 

Non-Functional Cysts

These cysts can either be benign or can indicate more serious issues. They include the following.

Cystadenomas 

An ovarian cystadenoma is a non-functional cyst, typically a benign tumor filled with clear or mucus-like fluid, categorized into serous or mucinous types. It rarely comes with symptoms or complications, but when symptoms show, they can include abdominal pain, discomfort, and bloating. If they need to be removed, they can be easily removed through surgery. 

Endometriomas

Often referred to as "chocolate cysts," endometriomas result from endometrial tissue growth within the ovaries, associated with endometriosis. They contain old menstrual blood, causing dark brown discoloration.

Although their exact cause is unclear, studies suggest they can be caused by retrograde menstruation—menstrual blood traveling backward through fallopian tubes and implanting endometrial cells on ovaries. According to research, endometriosis notably raises infertility risk. Treatment includes surgical interventions and medication to manage symptoms and preserve fertility.

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 often triggers symptoms such as acne, excessive hair, fatigue, hair loss, weight fluctuations, and fertility challenges. PCOS symptoms are manageable through medication but the disease itself is currently not curable. 

Diagnosing an Ovarian Cyst

An ovarian cyst is usually diagnosed during a pelvic exam or test like a pelvic ultrasound.  Corpus luteum cysts are normal to see during pregnancy. Your doctor may also use a tumor marker test, that checks for blood levels of a protein called a cancer antigen often are elevated in ovarian cancer. If your cyst is solid and you're at risk of ovarian cancer, your provider might order a cancer antigen 125 (CA 125) test or follow this test up with other blood tests to check for endometriosis and pelvic inflammatory disease.

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 Ivy Fertility. The compassionate healthcare professionals at the clinic will offer you several treatment options available that can promote pregnancy. 

How Are Ovarian Cysts Treated?

Treatment approaches for ovarian cysts differ based on type and severity. Typically, benign and symptomless cysts warrant close observation through periodic ultrasounds but often resolve independently within months.

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

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.