Can an ovarian cyst stop my conceiving or pregnancy?

An ovarian cyst is a fluid-filled sac that forms on or inside a woman's ovary, the two organs responsible for producing eggs and certain hormones in women. Most ovarian cysts aren't dangerous to a woman's health, which is good considering they most often occur between puberty and menopause -- during a woman's child-bearing years. Most cysts are benign, meaning they are not cancerous. For women planning on having children, the issue of a cyst can raise plenty of questions. In this article, we'll look at how ovarian cysts affect a woman's body, in particular her fertility.

Will having an ovarian cyst affect my fertility?

Ovarian cysts do not usually affect your fertility. However, some types of surgery to remove cysts can affect your ability to have a child. Most women who get an ovarian cyst have a functional cyst, which is usually small and will go away by itself. This type of cyst will not affect your ability to have a child. Ovarian cysts will usually only affect your fertility because of a condition called polycystic ovary syndrome. This is when you have many cysts (usually at least 10) on your ovary. However, if you have an ovarian cyst that needs treatment, some types of surgery can affect your fertility. This will depend on the type of surgery you have.

If you're having surgery to remove an ovarian cyst, there is a small risk of fertility problems as a result of complications from the procedure, for example, if you start to bleed more than is expected. The risk is lower if your gynaecologist (a doctor specializing in women’s reproductive health) does a keyhole procedure called a gynecological laparoscopy (in which small instruments and a tube-like telescopic camera are inserted through small cuts in your abdomen to remove your ovarian cyst). Your gynaecologist will explain how these risks apply to you before you have the operation. If you're having surgery to remove an ovary or fallopian tube, you will normally still be able to have a child as long as you have one ovary left, or even part of an ovary. Your gynaecologist will usually only recommend removing your ovary or fallopian tube if there is a problem. It’s likely that your gynaecologist will try to preserve as much ovarian tissue as he or she can, which will help with your fertility and prevent you going through the menopause early. If your ovarian cyst is found to be malignant, you may be advised to have a full hysterectomy (operation to remove your womb) to help prevent the cancer from spreading. This operation will mean you will no longer be able to become pregnant. Your gynaecologist will discuss the different options available to you before you have any surgery. If you feel unhappy with what he or she is suggesting, then you may be able to ask for a second opinion.

Do ovarian cysts lower your chances of falling pregnant?

Yes, ovarian cysts affect your fertility. They are not just a pain that you feel; they contribute to 'insulin resistance', which results in your body converting more energy into fat so you gain weight and your chances of falling pregnant fast are lowered dramatically. They often occur due to imbalances with the female reproductive hormones and these imbalances can be a major contributor to weight gain and lowered fertility potential.

Does having an ovarian cyst mean I have cancer?

No. Most ovarian cysts are benign (not cancerous). A very small proportion of ovarian cysts do turn out to be cancerous. The chance that your ovarian cyst is malignant (cancerous) will depend on your individual circumstances, including the exact type of ovarian cyst you have. Functional cysts (the most common type of ovarian cyst found in women before the menopause) are mostly benign. Some other types of ovarian cysts do turn out to be cancerous. The chances of an ovarian cyst being cancerous are outlined below.

About one in 1,000 ovarian cysts are found to be cancerous in women who have not yet gone through the menopause.

About three in 1,000 ovarian cysts turn out to be cancerous in women over the age of 50.

However, this figure also depends on the exact type of cyst you have. It also depends on other factors in your medical history, such as being infertile, having had breast cancer or relatives who have breast cancer, and whether or not you smoke. You will have a number of tests to check whether your ovarian cyst is benign or malignant. Talk to your GP if you're worried about your chance of having ovarian cancer.

Is there a link between ovarian cysts and fertility?

Some ovarian cysts can be associated with decreased fertility. However, it depends on the type of ovarian cyst you have. Ovarian cysts that can affect your fertility include:

·         Endometriomas - Endometriomas are cysts caused by endometriosis, a condition in which the tissue normally lining your uterus (endometrium) grows outside the uterus. These ovarian cysts may be associated with fertility problems.

·         Ovarian cysts resulting from polycystic ovary syndrome - Polycystic ovary syndrome (PCOS) is a condition marked by many small cysts in your ovaries, irregular periods and high levels of certain hormones. PCOS contributes to problems with fertility in some women. Unless they become very large, these types of ovarian cysts don't affect fertility:

·         Functional cysts - Such as follicular cysts or corpus luteum cysts — are the most common type of ovarian cyst. Functional cysts form during a normal menstrual cycle and don't cause or contribute to infertility. In fact, functional cysts actually indicate that the necessary functions leading to fertility are taking place.

·         Cystadenomas - Cystadenomas are growths in the ovary that arise from the surface of the ovaries. Although they need treatment, they don't affect fertility.

·         Dermoid cysts - These cysts contain tissue - such as skin, hair or even teeth instead of fluid. Dermoid cysts aren't associated with infertility.

What are ovarian cysts and how do they affect my fertility?

 Ovarian cysts often manifest as an irregularity of ovulation, dramatically decreasing your chances of falling pregnant naturally.  Normally the ovary develops a cyst that holds the egg every month during the normal menstrual cycle. When an egg is mature, the sac breaks open to release the egg, so it can travel through the fallopian tube for fertilization. Then the sac dissolves.

One irregularity is when the sac doesn't break open to release the egg and the cyst continues to grow. Another type of cyst can form after a successful ovulation when the sac doesn't dissolve afterwards. Instead, the sac seals off after the egg is released. Fluid then builds up inside of it and forms a cyst that can grow up to four inches or more and bleed, twist the ovary or cause pain.

Another reason you may form cysts is 'Estrogen dominance', an imbalance where excess estrogen contributes to weight gain and lowered fertility. Other female hormonal imbalances such as PCOS, Fibroids and Endometriosis may be causing your Cysts to form.

This can be caused by endocrine-disrupting chemicals (EDC's) that are common in our everyday life. These are environmental pollutants such as hormones in meat, plastics, and chemicals found in household products like cleaning products and make up. These chemicals mimic or block the action of our own hormones, setting the body up for the "right environment" for cysts to form. The problem is that once you have a cyst it can be like a "vicious cycle" as the cyst can continue to feed excess estrogen into your system.

What will happen if I'm diagnosed with an ovarian cyst while I’m pregnant?

If you're found to have an ovarian cyst while you’re pregnant, your doctor will usually just need to monitor it. Most ovarian cysts are benign and go away on their own. Occasionally, you may need to have the cyst removed before you have your baby. As women have a number of scans during their pregnancy, ovarian cysts are often diagnosed at this time. The majority of ovarian cysts found during pregnancy are small (under 5cm) and harmless – your doctor will probably just need to monitor it. This may mean having additional ultrasound scans carried out during your pregnancy.

Having an ovarian cyst won't harm your baby. However, if your ovarian cyst is large (over 7cm) or is suspected of being cancerous, you may need to have it removed. Laparoscopic (keyhole) surgery is a safe and effective procedure that can be carried out at any time during your pregnancy. However, you may be advised to wait to have the operation until after you have given birth to your baby.

Does the cyst have any bearing on my being unable to fall pregnant?

An ovarian cyst does not usually affect a woman's ability to conceive. The fact that you have been pregnant before is a good indicator that you will be able to conceive again. The length of time it takes for a woman to become pregnant varies greatly. No investigations are usually advised until a couple has been trying to conceive for a year with regular intercourse (at least twice a week). The only condition in which ovarian cysts are linked with difficulty in conceiving is polycystic ovary syndrome (PCOS). Women who have it tend to be overweight, have excessive hair growth and suffer from irregular or inon-existant periods. No single test can diagnose the syndrome, but blood tests for hormone levels and an ultrasound scan are helpful. It doesn't sound as though you have any symptoms suggestive of this condition. It is likely that you will conceive before long. In the meantime it would be a good idea to make sure that you are fit and well and that your body is ready to become pregnant. Try to ensure that you have a good varied diet and that you exercise regularly. If you smoke try to stop and cut down on your alcohol intake. Getting plenty of sleep and making time for relaxation are also important. Women trying to conceive should take daily folic acid supplements and continue with this for the first twelve weeks of pregnancy.

What are the symptoms of Ovarian Cysts?

Most cysts don't cause any symptoms and go away on their own. A large ovarian cyst can cause abdominal discomfort. If a large cyst presses on your bladder, you may feel the need to urinate more frequently because bladder capacity is reduced. The symptoms of ovarian cysts, if present, may include:

·         Menstrual irregularities

·         Pelvic pain - a constant or intermittent dull ache that may radiate to your lower back and thighs

·         Pelvic pain shortly before your period begins or just before it ends

·         Pelvic pain during intercourse  

·         Pain during bowel movements or pressure on your bowels

·         Nausea, vomiting or breast tenderness similar to that experienced during pregnancy

·         Fullness or heaviness in your abdomen

·         Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely

Are ovarian cysts and pelvic inflammatory disease linked?

Although ovarian cysts and pelvic inflammatory disease have similar symptoms, the two conditions are very different. Ovarian cysts are not caused by an infection, but pelvic inflammatory disease is mostly caused by a sexually transmitted infection (STI). You may or may not have any symptoms if you have either ovarian cysts or pelvic inflammatory disease. Many women have these conditions without knowing it. If you do have symptoms, these may include pain in your abdomen (tummy) and pain during sexual intercourse.

If you have an ovarian cyst, you may have other symptoms, which include:

·         Difficulty with or changes in your bowel movements

·         Needing to urinate more often or having trouble urinating

·         Indigestion or heartburn, or feeling very full after eating

If you have pelvic inflammatory disease, you may have other symptoms, which include:

·         An abnormal vaginal discharge that may be smelly

·         Irregular periods, bleeding between periods or having heavier periods than usual

·         Pain when you pass urine

·         A high temperature (over 38ºC)

·         Feeling sick or vomiting

If you have any of these symptoms, see your GP. If you’re diagnosed with ovarian cysts, you may not need any treatment because certain types of cysts will often go away on their own in about two or three months. If you’re diagnosed with pelvic inflammatory disease, your GP will prescribe you antibiotics to treat the infection.