Can Ovarian Cysts Cause Infertility?

Key Takeaways

• “Ovarian cyst” is a catch-all term for both cysts that are part of a normal menstrual cycle as well as abnormal cysts. 
• Many ovarian cysts won’t affect your chances of getting pregnant – they’re often just part of how the ovary facilitates ovulation. However, some cysts are linked to conditions that can impact fertility, such as endometriosis and polycystic ovary syndrome (PCOS).
• Diagnosis usually involves a pelvic exam, ultrasound, and sometimes a blood test. Treatment depends on the type and size of the cyst, as well as your symptoms.
• If you have any concerns about ovarian cysts, it's essential to talk to your doctor.

What Is an Ovarian Cyst?

The term “ovarian cyst” is a general and non-specific term. Every time a woman ovulates, this process is accomplished by a fluid-filled sac (called a cyst) within the ovary that grows to about the size of a quarter. The cyst then ruptures to release the egg and spends the next two weeks as a “corpus luteum” cyst, which is responsible for making estrogen and progesterone to support a pregnancy. After two more weeks, the corpus luteum dies, unless there is a pregnancy, and the process restarts. So, in normal ovulating women, one would expect to see cysts within the ovary of various sizes and densities. In fact, if there are no cysts seen in the ovary, that implies that there are no functional eggs to be seen. So, cysts are an expected and normal part of the female reproductive system.

However, the term “ovarian cyst” can also refer to other non-normal growths within the ovary – so drilling down exactly what is meant by “ovarian cyst” is critical for context.

Types of Ovarian Cysts

Functional cysts and non-functional cysts make up the two main categories of ovarian cysts. Let’s break them down below.

Functional Cysts

Functional cysts, the most common type, typically resolve on their own. They are linked to the normal menstrual cycle as described previously and can occur when a follicle, which normally releases an egg, doesn't rupture. They can also form after an egg is released, and the corpus luteum, which usually shrinks, continues to grow and fill with fluid.

Non-Functional

Non-functional ovarian cysts are not related to the menstrual cycle and can be more serious. They are called “non-functional” because they are not producing hormones (such as estrogen and progesterone).

Some types of non-functional ovarian cysts include:

• Non-functional simple cysts: These are often cysts where the egg failed to ovulate and therefore the cyst that held the egg remains intact after ovulation should have occurred. In these cases, there is often a moderate sized (2-3 cm) cyst that is simple on ultrasound. This means it appears to be full of clear fluid (not blood, or solid components). In the vast majority of cases, these will simply resolve with time. If they fail to resolve, there are a variety of different management options for dealing with them.  

• Dermoid cysts: These contain hair, skin, teeth, or other tissue types. They are usually benign.
• Endometriomas: These cysts grow from endometrial (uterine) tissue that has migrated to the ovary. They can cause pain, especially during menstruation. Cysts related to endometriosis may also harm ovarian tissue and therefore affect fertility.
• Cystadenomas: These fluid-filled cysts can grow quite large. According to the , theNational Institute of Healthy are usually benign, but some types can become cancerous.
• Polycystic Ovary Syndrome (PCOS): This is a hormonal disorder where multiple small cysts develop on the ovaries. It can cause irregular periods, acne, and hair loss. PCOS is a common cause of infertility, affecting 5 to 10% of women of reproductive age according to the National Library of Medicine.
• Paraovarian cysts: These develop near the ovary but are not attached to it.
• Cysts associated with ovarian cancer: Some ovarian cancers can present as a cyst. However the vast majority of such abnormal cysts have unique patterns that raise specific cause for concern on ultrasound evaluation. 

Symptoms of Ovarian Cysts

Most ovarian cysts don’t cause symptoms, and many people remain unaware of their presence – as most of the time ovarian cysts are just part of how the female reproductive system is designed to operate. However, in some cases, a cyst may grow too large or rupture, leading to various unpleasant symptoms. Signs of a large or ruptured cyst can include:

• Sporadic pelvic pain, ranging from dull to sharp, below the belly button.
• Abdominal pressure or heaviness.
• Bloating.

Additionally, conditions like endometriosis can contribute to the formation of non-functional ovarian cysts that may lead to menstrual irregularities, pain during sexual intercourse or urination, changes in hair quantity or texture, acne, and more.

Treating Ovarian Cysts

Most functional cysts resolve without intervention, and so a “watchful waiting” approach can be taken. However, when hurting or discomfort is involved, over-the-counter pain relievers can ease the irritation. If cysts are large, persistent, or affecting fertility, surgical removal may be necessary.

When to See a Doctor

If you’re experiencing persistent pain, missed or irregular periods, or discomfort, it’s important to consult a fertility specialist and get to the bottom of your issues. Furthermore, if you’ve been trying to conceive and are experiencing difficulties, seek professional guidance from a fertility care expert. San Diego Fertility Center’s compassionate team is here to support you on your journey. Reach out today to schedule a consultation.

This article provides general information and should not replace personalized medical advice. Always consult a healthcare professional for accurate diagnosis and tailored recommendations.