Ovarian cysts are common, and in many cases, they are harmless and disappear on their own. But when it comes to fertility, the type of cyst and how it’s managed can make a difference in a woman’s fertility. Here is a breakdown of the different types of ovarian cysts and which ones could cause issues in conceiving.
What Are Ovarian Cysts?
An ovarian cyst is a fluid-filled sac that forms on or within the ovary. They can occur as part of the normal menstrual cycle or arise from underlying conditions. Most ovarian cysts are found during routine exams or imaging and usually don’t cause symptoms. While many cysts are benign and disappear on their own, some may impact fertility more than others.
Types of Ovarian Cysts & Their Impact on Fertility
Functional Cysts
These include follicular cysts and corpus luteum cysts, which form during the menstrual cycle. They are the most common type and typically harmless. Functional cysts are the most common type, typically harmless, is normal part of ovulation, and rarely affect fertility. Most resolve on their own within a few menstrual cycles.
Polycystic Ovary Syndrome (PCOS) Related Cysts
PCOS is a hormonal condition in which the ovaries develop many small cyst-like follicles. These aren’t “cysts” in the traditional sense but represent arrested follicle growth. PCOS affects ovulation frequency, and irregular or absent ovulation can make conceiving naturally more difficult.
Endometriomas (Endometriosis-Associated Cysts)
Also known as “chocolate cysts,” endometriomas are linked to endometriosis. Endometriosis tissue grows outside the uterus and can attach to the ovary. These cysts can interfere with ovarian function, scar tissue can distort reproductive anatomy, and chronic inflammation may reduce egg quality and ovarian reserve. Studies show that endometriomas, especially larger ones can negatively impact Anti-Müllerian Hormone (AMH) and Antral Follicle Count (AFC).
Dermoid Cysts & Cystadenomas
These are benign growths that may contain tissue such as skin or fluid. They usually do not affect fertility directly, though large cysts can cause pain or ovarian torsion (twisting) and might require surgical removal.
When Ovarian Cysts Affect Fertility
Most ovarian cysts don’t interfere with the ability to conceive. But certain situations can raise concern:
- Cysts that disrupt ovulation or damage ovarian tissue can make conceiving more difficult such as those from PCOS or endometriosis.
- Large or persistent cysts that cause pain, twist the ovary (ovarian torsion), or impact ovarian reserve markers may need medical intervention.
- Surgical removal of cysts, especially if healthy ovarian tissue is inadvertently removed along with the cyst can lead to a reduction in ovarian reserve.
It’s also important to recognize that in conditions like PCOS, it’s not the cysts themselves but rather the underlying hormonal imbalance and irregular ovulation that interferes with fertility.
Fertility-Focused Evaluation and Treatment
Specializing in female fertility, Dr. Shahryar Kavoussi shares “Our goal is always to protect and optimize ovarian function. We assess the type of cyst and the patient’s overall fertility, then develop a plan whether that’s monitoring, hormonal therapy, minimally invasive surgery, or fertility-enhancing treatments.”
Evaluation and treatment may include:
- Careful Evaluation & Monitoring
- Hormonal Regulation
- Surgical Management
- Fertility Support & Assisted Reproductive Technologies
While most ovarian cysts don’t prevent pregnancy, certain types especially those associated with PCOS or endometriosis can cause issues in getting pregnant. The key is recognizing when an ovarian cyst is harmless and will resolve itself versus when it warrants closer attention and proactive care.
If you’re concerned about ovarian cysts or your fertility, consider consulting with a reproductive endocrinologist about getting a fertility evaluation.
