Ovarian Cysts and Fertility

Microscopic View of an Ovarian Follicle

 

The most common form of ovarian cysts, functional cysts, does not affect fertility. In fact, functional cysts form when everything is functioning properly with the woman’s reproductive system. However, some types of ovarian cysts do have a negative impact on fertility.

The tissue that normally lines the uterus is called the endometrium. Endometriosis is a condition characterized by the endometrium growing outside the uterus. The endometrium can grow abnormally anywhere inside the pelvic region, including the fallopian tubes and on the ovaries. In rare cases, the endometrium can grow outside the pelvic cavity, such as in the lungs or even the brain.

If a woman develops endometriosis, cysts of endometrial tissue called endometriomas form. Endometriomas can be painful and can interfere with normal ovulation. Women with mild cases of endometriosis often take longer to conceive. Fertility problems are worse for women with moderate to severe endometriosis. Up to 40% of women who have endometriosis become infertile due to the condition.

Endometriosis is a difficult condition to diagnose. The gynecologist may order an ultrasound to look for endometriomas. Even if cysts are found on the ultrasound, it cannot provide a definite diagnosis. The only way to confirm the diagnosis is to perform a biopsy of the cysts. The treatment to improve fertility that has been compromised by endometriosis is the surgical removal, burning, or draining of the endometriomas.

Cysts on the ovaries can negatively affect fertility by causing irregular menstrual periods and high levels of hormones. Polycystic ovary syndrome (PCOS), also called Stein-Levanthal syndrome, causes small cysts on the ovaries. A woman with polycystic ovary syndrome may stop having menstrual periods.

Treatment for polycystic ovary syndrome depends on the symptoms that the woman is experiencing. If fertility is the concern and the woman is overweight, the doctor may suggest that she meet with a dietician or nutritionist to lose the weight. Women diagnosed with polycystic ovary syndrome have had some success with increasing fertility by losing excess weight.

If other treatments have not been effective to increase fertility, the physician may recommend a procedure called ovarian drilling. Ovarian drilling is a surgical procedure for inducing ovulation. During the ovarian drilling procedure, a small piece of the ovary is destroyed with an electric current. The electric current is administered by a needle inserted in the ovary.

For a woman who wants to become pregnant, a routine gynecological screening is always a good idea. If a woman is having pelvic pain or irregular periods, she should consult her gynecologist whether or not she intends to get pregnant.   

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