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Pregnancy and cyst. Pregnancy and Ovarian Cysts: Management, Types, and Fertility Impact

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How do ovarian cysts affect pregnancy chances. What are the different types of ovarian cysts. Can ovarian cysts cause infertility. How are ovarian cysts managed during pregnancy. What treatment options exist for ovarian cysts while trying to conceive.

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Understanding Ovarian Cysts and Their Impact on Fertility

Ovarian cysts are fluid-filled sacs that develop on the ovaries. While they’re a common occurrence in many women, they can sometimes impact fertility and pregnancy. However, it’s important to note that in most cases, ovarian cysts don’t cause infertility or prevent pregnancy.

Do ovarian cysts always prevent pregnancy? No, most ovarian cysts are harmless and don’t interfere with conception. However, certain types of cysts or underlying conditions causing cysts may make it more challenging to get pregnant.

Common Signs and Symptoms of Ovarian Cysts

Many women with ovarian cysts don’t experience any symptoms. However, when symptoms do occur, they may include:

  • Pelvic pain or discomfort
  • Bloating or swelling in the abdomen
  • Pain during intercourse
  • Changes in menstrual cycle
  • Frequent urination
  • Feeling of fullness even after eating small amounts

Can ovarian cysts cause pain during pregnancy? Yes, some women may experience discomfort or pain from ovarian cysts during pregnancy, especially if the cysts grow larger or rupture.

Types of Ovarian Cysts and Their Fertility Implications

Understanding the different types of ovarian cysts can help you better comprehend their potential impact on fertility. Here are the main types:

Functional Cysts

Functional cysts are the most common type and typically don’t affect fertility. They include:

  • Follicle cysts: These occur when a follicle doesn’t release an egg and continues to grow.
  • Corpus luteum cysts: These form after an egg is released and the follicle reseals itself.

Do functional cysts resolve on their own? Yes, most functional cysts disappear within a few weeks to months without treatment.

Endometriomas

Endometriomas are cysts caused by endometriosis, a condition where uterine tissue grows outside the uterus. These cysts can be painful and may impact fertility.

Dermoid Cysts

Dermoid cysts are unusual growths that can contain various types of tissue, including hair, teeth, or bone. While they don’t typically affect fertility directly, they may need to be removed if they grow large or cause complications.

Cystadenomas

Cystadenomas are often large, fluid-filled cysts that can cause discomfort due to their size. While they don’t directly cause infertility, their presence may complicate pregnancy if left untreated.

Causes of Ovarian Cysts and Their Relation to Fertility

Understanding the causes of ovarian cysts can provide insight into their potential impact on fertility. Some common causes include:

Hormonal Fluctuations

Many ovarian cysts form as a result of the normal menstrual cycle. These functional cysts typically don’t affect fertility and often resolve on their own.

Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder that can cause multiple small cysts to form on the ovaries. It’s one of the leading causes of infertility in women.

How does PCOS affect fertility? PCOS can disrupt normal ovulation, making it more difficult to conceive. Women with PCOS may have irregular periods or fail to ovulate regularly.

Endometriosis

Endometriosis can cause endometriomas, or “chocolate cysts,” to form on the ovaries. This condition can impact fertility by affecting egg quality, altering the pelvic environment, or causing scarring that interferes with conception.

Treatment Options for Ovarian Cysts While Trying to Conceive

If you’re trying to get pregnant and have ovarian cysts, your treatment options may depend on the type and size of the cysts, as well as your overall health and fertility goals.

Watchful Waiting

For many functional cysts, doctors may recommend a “wait and see” approach, as these cysts often resolve on their own within a few menstrual cycles.

Hormonal Birth Control

While not an option if you’re actively trying to conceive, hormonal birth control can be used to prevent new cysts from forming in some cases.

Surgery

In some cases, surgical removal of cysts may be necessary, especially for large cysts or those that don’t resolve on their own.

Is surgery for ovarian cysts safe during pregnancy? While it’s generally avoided if possible, surgery for ovarian cysts during pregnancy can be performed safely if necessary, typically during the second trimester.

Fertility Treatments

For women with PCOS or other cyst-related fertility issues, treatments such as ovulation induction medications or in vitro fertilization (IVF) may be recommended.

Managing Ovarian Cysts During Pregnancy

If you become pregnant while having ovarian cysts, or if cysts develop during pregnancy, careful management is essential.

Monitoring

Your healthcare provider will likely monitor any existing cysts through regular ultrasounds to ensure they’re not growing or causing complications.

Treatment Considerations

Most ovarian cysts during pregnancy don’t require treatment and may resolve on their own. However, if a cyst is large, growing, or causing symptoms, your doctor may recommend treatment.

Can ovarian cysts be removed during pregnancy? Yes, in some cases, surgical removal of ovarian cysts during pregnancy may be necessary, typically performed during the second trimester when risks are lowest.

Fertility-Friendly Lifestyle Changes for Women with Ovarian Cysts

While not all ovarian cysts can be prevented, certain lifestyle changes may help manage symptoms and support overall reproductive health:

  • Maintain a healthy weight
  • Exercise regularly
  • Eat a balanced diet rich in fruits, vegetables, and whole grains
  • Manage stress through relaxation techniques or meditation
  • Avoid smoking and limit alcohol consumption

Can dietary changes help manage ovarian cysts? While diet alone can’t cure ovarian cysts, a healthy, balanced diet may help regulate hormones and reduce inflammation, which could potentially help manage symptoms associated with certain types of cysts.

When to Seek Medical Advice for Ovarian Cysts and Fertility Concerns

If you’re trying to conceive and suspect you have ovarian cysts, or if you’re experiencing symptoms that could indicate cysts, it’s important to consult with a healthcare provider. Seek medical attention if you experience:

  • Severe pelvic pain
  • Fever
  • Rapid breathing
  • Dizziness or weakness
  • Sudden, sharp abdominal pain

These symptoms could indicate a ruptured cyst or other complications that require immediate medical attention.

How often should ovarian cysts be monitored? The frequency of monitoring depends on the type and size of the cyst, as well as individual factors. Your healthcare provider will recommend an appropriate monitoring schedule based on your specific situation.

Advances in Ovarian Cyst Research and Future Treatments

Research into ovarian cysts and their impact on fertility is ongoing. Some promising areas of study include:

Improved Diagnostic Tools

Researchers are working on developing more accurate and less invasive methods for diagnosing and characterizing ovarian cysts.

Novel Treatment Approaches

New treatments being explored include targeted therapies for specific types of cysts and minimally invasive surgical techniques.

Fertility Preservation Techniques

Advancements in fertility preservation methods may offer new options for women with ovarian cysts who wish to have children in the future.

What new treatments for ovarian cysts are on the horizon? While research is ongoing, potential future treatments may include more targeted medications to shrink cysts, advanced imaging techniques for earlier detection, and improved surgical methods that better preserve ovarian function.

In conclusion, while ovarian cysts can sometimes complicate the journey to pregnancy, they don’t necessarily prevent conception. Understanding the type of cysts you have, working closely with your healthcare provider, and maintaining overall reproductive health can help optimize your chances of conceiving. Remember, each woman’s situation is unique, and personalized medical advice is crucial when navigating fertility challenges related to ovarian cysts.

How to Get Pregnant with Ovarian Cysts: 5 Tips

Medically reviewed on August 17, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

  • Know the signs of ovarian cysts
  • Learn more about different types of ovarian cysts
  • Understand the causes of ovarian cysts
  • Consider your ovarian cyst treatment options
  • Discover other potential causes of infertility
  • Learn more about your fertility levels with Everlywell

When you’re trying to get pregnant, you’ll experience a wide range of feelings. Excitement, anticipation, nervousness, and hope are all common stops on the roller coaster of emotions. If you don’t get pregnant right away, fear can begin to push aside those other emotions.

You might wonder what is causing your inability to get pregnant. Perhaps you know or think that you have ovarian cysts. Can they cause infertility?

Luckily, this common condition doesn’t typically cause female infertility. However, ovarian cysts can make it more difficult to conceive and may also contribute to other health problems. This guide will help you better understand how to get pregnant with ovarian cysts and other factors that might contribute to fertility problems.

Hearing the words ovarian cyst may frighten some and can lead to a questions, like do ovarian cysts cause infertility issues? Are ovarian cysts genetic? Can stress cause ovarian cysts?, etc. If you have an ovarian cyst, it’s important to first understand what it is, the signs of it, and the type you have.

Ovarian cysts are sacs that fill with fluid. They develop on your ovaries and typically occur naturally. They don’t usually cause problems and often go away without requiring any treatment. In fact, you often won’t even know that you have an ovarian cyst.

However, sometimes ovarian cysts make themselves known. If the cyst is very large or it ruptures, you will likely experience symptoms that might include:

  • Pain during intercourse
  • Changes to bleeding during your menstrual cycle
  • Pelvic pain
  • Bloating in your stomach
  • Needing to urinate more frequently
  • Persistent feeling of fullness, even when you don’t eat very much

Some people may also experience temporary difficulty becoming pregnant if an ovarian cyst ruptures, although this isn’t very common.

Tip #2: Learn more about different types of ovarian cysts

There are several different types of ovarian cysts and varying reasons why they might form. Understanding your specific case can help you and your healthcare provider determine the right path forward for you to reach your health and fertility goals.

Five different types of benign, non-cancerous cysts can form in the ovaries. These include: [1]

  • Follicle cysts – What is a follicle on the ovary exactly and how do such cysts occur? These functional cysts occur when a follicle in your ovaries doesn’t break open and release the egg it contains. The follicle grows into a small cyst. The follicular cyst will go away on its own within three months and doesn’t cause pain or discomfort.
  • Corpus luteum cysts – If the follicle containing your egg opens and releases the egg, the remaining material, called the corpus luteum, can still cause a cyst to form. If it reseals itself, it may fill with fluid. This type of functional cyst can go away on its own in a few weeks. However, sometimes they can get very large and cause pain and bleeding.
  • Endometriomas – If you suffer from endometriosis, endometriomas are the cysts caused when the uterine tissue grows outside of the uterus. They can be extremely painful and can cause other problems.
  • Dermoids – These relatively rare cysts can form on the ovaries after you’ve given birth. They are sac-like growths that contain tissue such as hair, bone, teeth, and fluids. Dermoids might be very small or very large. Because they can be problematic if they burst, many people choose to have them removed.
  • Cystadenomas – Cystenomas tend to be very large in size. They are filled with fluid and can cause pain and discomfort due to their size.

Tip #3: Understand the causes of ovarian cysts

Whether you are experiencing a dermoid, a follicle cyst, or a corpus luteum cyst, ovarian cysts can have several common causes. Some of the most common reasons you might get ovarian cysts can include: [2]

  • As the natural result of the menstrual cycle – When you ovulate, your body releases an egg from a follicle on your ovary. If the follicle doesn’t open and release the egg or the remaining tissue might reseal itself and trap liquid inside. Either of these situations can result in a cyst that will typically go away on its own.
  • Polycystic ovarian syndrome (PCOS) – Certain hormonal conditions, such as polycystic ovarian syndrome, can also cause cysts to form on the ovaries. PCOS is a condition where the body produces excessive androgens. A high level of androgens can prevent ovulation, thus resulting in small cysts developing in follicles on the ovaries.
  • Pelvic infections – A serious pelvic infection can cause cysts to form. These cysts pose a serious risk if they become infected and rupture. They can cause sepsis and must be treated with antibiotics or they could become deadly.
  • Endometriosis – Endometriosis is a condition where uterine tissue grows outside of the uterus in other areas of the body, including the ovaries. This excess tissue can cause cysts to form. Over time, the cysts may burst, leading to painful scar tissue and a host of health problems.
  • Cancer – The vast majority of ovarian cysts are benign. However, some can become malignant or cancerous. If your healthcare provider suspects that you have a tumor rather than a cyst on your ovaries, they will perform a battery of tests to confirm the diagnosis. It’s important to note that cancerous cysts are more common in those who are past menopause.

Tip #4: Consider your ovarian cyst treatment options

Many ovarian cysts resolve on their own without necessitating any treatment. In some cases, you won’t even know that you had an ovarian cyst because you won’t feel any pain or discomfort.

However, other cysts can cause symptoms and may require treatment. If you suspect that ovarian cysts are causing you pain and discomfort, the only way to know for sure is to visit your healthcare provider. There, your healthcare provider might use one of several methods to test for cysts, including: [2]

  • An ultrasound
  • A pregnancy test to ensure that you aren’t pregnant
  • A blood test if you are post-menopausal to rule out cancerous tumors
  • Hormone level tests

Once your healthcare provider has confirmed that ovarian cysts are the culprit behind your problems, you’ll have several options for treatment. The treatment options available and recommended depend on the type and severity of cysts you have. Treatments might include: [2]

  • Pain medication – If your ovarian cysts cause mild to moderate discomfort but don’t require surgery, your healthcare provider might recommend pain medication to mitigate your symptoms until the cysts go away. Sometimes over-the-counter medications are sufficient, although if the pain is too strong a prescription might be needed.
  • Hormonal birth control – Some forms of hormonal birth control prevent ovulation. If you don’t ovulate, you won’t have as high of a likelihood of cysts forming as the result of your menstrual cycle.
  • Surgery – In certain cases, surgery might be needed to remove ovarian cysts. If your cyst or cysts are growing, cause severe pain, don’t go away on their own, or look odd, your healthcare provider may recommend surgery to remove the cysts.

Tip #5: Discover other potential causes of infertility

In most cases, ovarian cysts don’t cause infertility. The one situation that differs slightly is if your cysts are caused by endometriosis. In the cause of endometriosis, the condition itself rather than the cysts can damage your ability to conceive. [3] This is because severe endometriosis can lead to scarring of your uterine lining and scar tissue that can block the release of eggs from your ovaries.

Endometriosis isn’t the only potential cause of infertility, however. Other causes may include: [4]

  • Structural problems – Some individuals struggle to become pregnant because the shape of the uterus makes it difficult for a fertilized egg to implant in the lining. If this happens, a viable pregnancy cannot occur. The fallopian tubes can also become blocked, thus preventing an egg from moving from the ovaries to the uterus.
  • Medical conditions – Certain autoimmune diseases may also interfere with fertility. These can include rheumatoid arthritis, lupus, and thyroid conditions.
  • Infections – Infections such as gonorrhea and chlamydia may also cause scarring. This scar tissue can block your fallopian tubes so that eggs cannot pass through to the uterus. HPV infections can harm your fertility.
  • Menstrual irregularities – Similar to endometriosis, the cysts caused by PCOS aren’t a direct cause of infertility. However, the hormonal imbalance and menstrual irregularities resulting from PCOS can interfere with your ability to become pregnant. Other menstrual irregularities such as the absence of your period, prolonged heavy periods, and very painful periods may also contribute to fertility problems.
  • Lifestyle factors – Finally, excessive alcohol use or smoking cigarettes may interfere with your fertility. Being very over or underweight can also cause you to have trouble conceiving. Eating a balanced diet, exercising, and getting plenty of healthy sleep can all help keep your body in prime shape.

Nonetheless, determining the cause can help you find the right fertility treatment option if needed.

Learn more about your fertility levels with Everlywell

Ovarian cysts are a common condition. They are often simply the result of your normal menstrual cycle and can resolve themselves without you ever knowing they were there. Certain health conditions such as PCOS and endometriosis may cause ovarian cysts and other symptoms. Typically, ovarian cysts aren’t the root cause of female infertility. Instead, a host of other factors might cause you to have difficulty becoming pregnant.

If you’ve been trying to get pregnant for over a year without success, it might be time to investigate the potential reasons why. The first step to determining why you haven’t conceived is to check your hormones.

The Everlywell Female Hormone Test measures specific, fertility-influencing hormones. Our easy-to-use, at-home testing kit can give you valuable insight into your body’s inner workings. This allows you to move forward armed with the information you need.

Related content

Are ovarian cysts genetic?

Can you get pregnant with one ovary?

Can stress cause ovarian cysts?

What is a follicle on the ovary?

How to shrink ovarian cysts naturally

References

  1. NHS. Ovarian Cysts. URL. Accessed August 17, 2022.
  2. Womenshealth.gov. Ovarian Cysts. URL. Accessed August 17, 2022.
  3. Planned Parenthood. Endometriosis. URL. Accessed August 17, 2022.
  4. NIH. Possible Causes of Female Infertility. URL. Accessed August 17, 2022.

What It Is and How to Treat

When you’re pregnant, it’s only natural to worry about every little thing that goes on in your body. After all, you want to ensure that everything is just right for that growing baby! So if you’ve been diagnosed with a corpus luteum cyst, you’re probably wondering what it is and what it means for baby. But rest assured that it’s a common condition that many women experience, whether they’re pregnant or not.

In this article:
What is a corpus luteum cyst?
Is a corpus luteum cyst dangerous?
Corpus luteum cyst symptoms
Corpus luteum cyst treatment

What Is a Corpus Luteum Cyst?

A corpus luteum cyst is simply a cyst that forms inside the corpus luteum. What’s that, you ask? Let’s review how ovulation works.

Every cycle, your body produces hormones that cause follicles—aka tiny fluid-filled sacs, each containing an immature egg—in one of your ovaries to start maturing. However, only one of the developing follicles will go on to form and then release a fully mature egg. Once it has released the egg, the empty follicle then transforms into the corpus luteum, a ball of cells that’s responsible for producing the hormone progesterone, explains Melissa R. Peskin-Stolze, MD, an ob-gyn and assistant professor of obstetrics and gynecology and women’s health at Montefiore Health System and Albert Einstein College of Medicine.

If an egg is fertilized and you become pregnant, hormones stimulate the corpus luteum to secrete progesterone until the placenta develops and takes over progesterone production for the remainder of the pregnancy, says Camaryn Chrisman Robbins, MD, a Washington University ob-gyn at the Women & Infants Center in St. Louis, Missouri.

If you don’t become pregnant that cycle, the corpus luteum breaks down and is shed along with the lining of your uterus in your next period.

Sometimes, a cyst can form in the corpus luteum, filled with fluid or blood. They can happen whether you become pregnant during the cycle or not, and happens when the corpus luteum fails to break down and instead continues to grow larger after it’s released the egg, Peskin-Stolze says.

If you’ve been diagnosed with a corpus luteum cyst, know that in the vast majority of cases, they’re completely benign and will resolve on their own. That’s the case even if you’re dealing with a corpus luteum cyst during pregnancy; they’re rarely harmful to the fetus.

Is a Corpus Luteum Cyst Dangerous During Pregnancy?

A luteal cyst is generally harmless and will usually go away on its own. “The corpus luteum works to support the early pregnancy, but if a cyst is still present on the corpus luteum by the end of the first trimester or early part of the second trimester, it usually resolves itself,” Peskin-Stolze says.

If that’s not the case, your doctor will likely just keep an eye on it and ask you questions at your regularly scheduled appointments about whether you’re experiencing any pain or discomfort. They may order an extra ultrasound now and then to monitor its size and make sure the cyst isn’t causing any issues for your ovary.

However, it’s possible (though unlikely) for a corpus luteum cyst to rupture or twist on the ovary’s blood supply, which could cause pain and, in rare cases, endanger your ovary, says Peskin-Stolze. Read on to learn more.

Corpus Luteum Cyst Rupture During Pregnancy

Though uncommon, a corpus luteum cyst can burst open, either spontaneously or because of an external factor like a pelvic exam, sex or exercise, says Robbins. In these cases, the greatest concern isn’t the impact on baby, but rather on the mom-to-be. “Usually the amount of bleeding is small, but in rare cases the cyst rupture can cause internal bleeding, requiring surgery.”

Corpus Luteum Cyst Torsion During Pregnancy

Even rarer than a corpus luteum cyst rupture is an event called torsion. This happens when an ovary with a cyst gets twisted around the artery and vein that make up its blood supply. “The heavy weight of the cyst swings around the blood supply, kind of like a tether ball game,” Peskin-Stolze explains. It’s more common in the early second trimester, as the uterus grows out of the pelvis. A torsion would also call for surgery.

Symptoms of a Corpus Luteum Cyst in Pregnancy

In many cases, there aren’t any corpus luteum cyst symptoms. In fact, most pregnant women don’t even know they have a corpus luteum cyst, especially if they skip that early ultrasound that doctors use to confirm a pregnancy. Other times they show up as part of a routine pregnancy ultrasound.

If you do experience corpus luteum cyst symptoms, the most common is typically a dull ache in your lower abdomen, says Robbins.

When to worry? If your pain suddenly becomes intense. According to Peskin-Stolze, the following are some symptoms you might experience if, in the unlikely event, you’ve had a corpus luteum cyst rupture or become twisted:

  • One-sided, sharp lower abdominal/pelvic pain
  • Moderate to severe pain that comes on quickly
  • Shoulder pain
  • Fainting and/or dizziness

If you experience any of the symptoms above, it’s important to seek medical attention. If your regular doctor is unavailable, or you experience these symptoms during off hours, it’s best to head to the Emergency Room to get checked out.

Corpus Luteum Cyst Treatment During Pregnancy

The best corpus luteum cyst treatment is often simply time, Pskin-Stolze says. Since most corpus luteum cysts resolve on their own, it doesn’t make sense to subject yourself to unnecessary medical procedures to get rid of the cyst.

If you’re experiencing minor corpus luteum cyst pain, it’s fine to take over-the-counter medication like Tylenol (ibuprofen, like Motrin and Advil, isn’t recommended during pregnancy). Heating pads and warm (not piping hot) baths can also be effective ways to reduce pain naturally. If you have a large corpus luteum cyst or take any medication that increases your likelihood of bleeding, your doctor may recommend abstaining from sex, Robbins says. But most women have no pain and don’t need to restrict their activities.

In the event of corpus luteum cyst torsion, you’d likely undergo laparoscopic surgery—but don’t worry, it can be performed safely and effectively in pregnant women. “Sometimes the ovary needs to be untwisted, with or without removal of the cyst that caused it to twist in the first place,” says Robbins. “In some cases, the blood supply has been pinched off too long and the ovary needs to be removed.” But rest assured, those cases are rare.

Updated February 2020

Expert bios:

Melissa R. Peskin-Stolze, MD, is an ob-gyn and assistant professor of obstetrics and gynecology and women’s health at Montefiore Health System and Albert Einstein College of Medicine. She earned her medical degree from Albany Medical College.

Camaryn Chrisman Robbins, MD, MPH, is a Washington University ob-gyn at the Women & Infants Center in St. Louis, Missouri. She received her medical degree from Wake Forest University in 2004.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

What Causes Abdominal Pain During Pregnancy (and How to Find Relief)

What to Do About Dizziness During Pregnancy

The Truth About Taking Baths During Pregnancy

Ovarian cyst during pregnancy. What is an ovarian cyst during pregnancy?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

An ovarian cyst during pregnancy is a volumetric neoplasm in the form of a cavity with liquid contents that can exist before fertilization or form after the conception of a child. With a small size of cysts, an asymptomatic course is possible, as the fetus grows, pains appear in the suprapubic region of varying intensity, radiating to the groin or sacrum, urination disorders, and constipation. For diagnosis, ultrasound of the pelvic organs is used, which is supplemented by color Doppler mapping. Conservative therapy is aimed at maintaining pregnancy and alleviating the condition. Removal of cysts is performed after the maturation of the placenta.

    ICD-10

    D27 Benign neoplasm of ovary

    • Causes
    • Pathogenesis
    • Classification
    • Symptoms
    • Complications
    • Diagnostics
    • Treatment

      • Conservative therapy
      • Surgical treatment
    • Prognosis and prevention
    • Prices for treatment

    General

    An ovarian cyst is more often detected in patients of late reproductive age, usually exists even before conception, due to hormonal and immune changes during gestation, it increases in volume. Cystic formations are diagnosed in 0.02-0.46% of women bearing a child. A direct relationship between the appearance of cysts and pregnancy has not been established. In adolescents and patients over 45 years of age, there is a risk of malignancy of the neoplasm under the influence of endocrine factors.

    ovarian cyst during pregnancy

    Causes

    The exact causes of ovarian cysts during pregnancy are unknown. The most popular theory suggests the influence of endocrine disorders, which can be provoked by external or internal factors, or a combination of them. The development of the disease is facilitated by:

    • Sexual infections. Chronic inflammatory diseases of the ovaries can cause disruption of proliferation processes in organ tissues. During pregnancy, the immune system weakens, the infection enters the active phase, which provokes the growth of the cyst.
    • Hormonal changes. Associated with a decrease in estrogen production and an increase in the stimulating effect of FSH. They cause diffuse and then focal hyperplasia and proliferation of ovarian cells.
    • Abortions. Termination of pregnancy causes fluctuations in the endocrine status, increases the risk of infection of the genital organs. This leads to a violation of the hormonal regulation of the sex glands and proliferative processes.
    • Heredity. The likelihood of developing the disease is increased in women who have a maternal history of ovarian cysts.
    • Prolonged absence of pregnancy. Regular ovulation is considered a damaging factor for ovarian tissue. If the patient does not become pregnant and does not take oral contraceptives that inhibit the ovaries and the maturation of the follicles, the risk of cyst formation increases.

    Pathogenesis

    The development of ovarian cysts often begins before pregnancy. Violation of neuroendocrine regulation leads to a weakening of the function of the sex glands. The stimulating effect of FSH triggers proliferation processes. The source of focal hyperplasia can be normal cells that form ovarian tissues, or the remains of embryonic rudiments. In the latter case, cysts prone to malignancy appear.

    With regular ovulation, ovarian tissue is damaged at the time of rupture of the follicle. The spilled liquid contains a large amount of estrogens, which increase cell proliferation. In older women, along with conventional estrogens, altered phenol steroids appear that can cause malignancy of cysts, so malignant tumors are often diagnosed in premenopausal pregnant women.

    Ovarian cysts found during pregnancy can also be due to endometriosis. The pathogenesis of endometrioid cysts is associated with retrograde reflux of menstrual blood or with the remnants of embryonic tissue in the gonads. Under the influence of hormonal fluctuations, the epithelium in the cyst cavity is rejected, but does not go beyond the capsule and forms its contents.

    Classification

    Ovarian cysts during pregnancy are classified according to the histological structure, less often – according to the mechanism of origin. The division into types is the same as for neoplasms that have arisen outside the period of gestation. Histological classification includes:

    • Epithelial. Serous, endometrioid, clear cell and mixed cysts, Brenner’s tumor.
    • From the stroma of the sex cord. Thecoma, fibroma.
    • Germinogenic. Dermoid cysts, chorionepitheliomas and ovarian struma.
    • Tumor-like processes. Endometriosis, pregnancy luteoma, superficial epithelial and paraovarian cysts, polycystic, hyperthecosis.

    Symptoms

    Clinical manifestations do not depend on the histological structure of the ovarian cyst during pregnancy. At an early stage, there are no signs of the disease, the duration of the asymptomatic course can reach several years. Subsequently, aching dull pains in the lower abdomen are periodically disturbed, which can radiate to the groin, perineum, and lumbosacral region. Sometimes, before conception, the patient does not know about the existence of a neoplasm, the diagnosis is made during registration and a routine examination.

    For the first trimester, the progression of symptoms is uncharacteristic. From 12-13 weeks, the uterus increases in size, changes the location of the appendages, can compress the cyst and cause tension in its capsule. Pain in the lower abdomen intensifies, especially with a change in body position. Acute pain indicates the development of complications – torsion of the legs of the ovarian cyst.

    Complications

    An ovarian cyst in 18% of cases causes a short-term abortion, the likelihood of complications is determined by the hormonal activity of the neoplasm and the existing risk factors for spontaneous miscarriage. In 12% of pregnant women, serous or dermoid cysts twist at the base. Torsion is accompanied by compression of the vessels supplying the tumor and tissue necrosis. Need emergency care and hospitalization in the gynecological department.

    In the 2-3 trimester, with neoplasms of a significant size, the fetus occupies the wrong position – oblique or transverse, which makes it difficult to give birth through the natural birth canal and becomes an indication for caesarean section. If the patient gives birth on her own, at the end of the 1st stage of labor, with the appearance of attempts, there is a possibility of rupture of the cyst capsule and the addition of an acute abdomen clinic.

    Large and inactive cystic masses can interfere with the advancement of the fetal head, so the preservation of the tumor before delivery increases the risk of labor anomalies and injuries in the newborn. Malignant degeneration of an ovarian cyst during pregnancy occurs in 25% of women with this pathology.

    Diagnostics

    Suspicion of an ovarian cyst may occur during examination or routine examination of a pregnant woman. The diagnosis is established in cooperation with an oncogynecologist or oncologist, who exclude the malignant nature of the tumor. The following diagnostic methods are used:

    • Gynecological examination. In a bimanual study over the Douglas space, a mobile tugoelastic formation is determined. The shape of a benign cyst is round or oval, the surface is smooth.
    • Gynecological ultrasound. A benign ovarian cyst during pregnancy looks like a smooth-walled single-chamber formation of a rounded shape with even contours. The contents are hypoechoic or anechoic.
    • CDC. Ovarian cysts are characterized by blood flow in single vessels located in the capsule. A large number of tortuous and irregularly shaped vessels testifies in favor of malignancy.
    • SA-125, SA 19-9. Tumor markers are determined for differential diagnosis with a malignant tumor. The analysis is highly specific, with an increase in the rate of more than 35 mU / ml, 78-100% of pregnant women are diagnosed with ovarian cancer.

    Treatment

    If an ovarian cyst is detected at the conception planning stage, surgical treatment is recommended before pregnancy. In other cases, tactics depend on the type of neoplasia. With follicular and luteal cysts, treatment is not always required, since in most women the formations disappear on their own within 2-3 cycles. For other types of cysts, hormonal therapy is used at the initial stage, with ineffectiveness, laparoscopic removal.

    Conservative therapy

    Treatment of ovarian cysts in early pregnancy is carried out by conservative methods, aimed at preserving the fetus and reducing unpleasant symptoms. A complete cure by medical methods is impossible. Hospitalization in the gynecology department is necessary in the first trimester when there is a threat of interruption of gestation. From the second trimester, women are sent to the department of pathology of pregnant women. The following groups of drugs are used:

    • Gestagens. Oral or vaginal progesterone tablets are indicated to maintain corpus luteum function and maintain pregnancy.
    • Antispasmodics. They are prescribed to reduce the tone of the myometrium. Pregnant women are allowed to take drugs based on drotaverine or papaverine in the form of tablets, rectal suppositories or injections.
    • β-blockers. They are used to reduce the tone of the uterus after 24 weeks. In the early stages, they are ineffective due to the lack of appropriate receptors.

    Surgical treatment

    In most patients, cysts up to 10 cm in diameter accidentally discovered in the 1st trimester are luteal and regress independently after the final formation of the placenta. For other tumors, surgery is indicated. If the ovarian cyst at the beginning of pregnancy proceeds without complications, the intervention is refrained until 16 weeks of gestation. With elevated tumor markers, surgical treatment is carried out as early as possible.

    Laparoscopic access is used, which reduces the risk of complications and shortens the rehabilitation period. When carrying out the operation at a later date, a laparotomy is performed. The volume of intervention is determined intraoperatively based on the results of an urgent histological examination, varies from cyst removal to ovarian resection. In severe cases, an oophorectomy is performed, which does not affect the bearing of the fetus.

    Prognosis and prevention

    The prognosis of ovarian cysts during pregnancy is usually favorable. Timely removal of the neoplasm allows you to bear the child and give birth on time. The reproductive function does not suffer, there are no contraindications for subsequent pregnancies. In order not to increase the risk of complications during the gestation period, cystic formations must be treated at the conception planning stage.

    Specific prevention of the disease has not been developed. Unprotected sex should be abandoned, timely treatment of inflammatory diseases of the genital organs should be carried out, and abortions should be avoided. Patients who do not plan pregnancy and do not have contraindications to hormone therapy are recommended to use oral contraceptives to prevent hyperplastic processes of the reproductive organs.

    You can share your medical history, what helped you in the treatment of ovarian cysts during pregnancy.

    Sources

    1. Obstetrics. National leadership / ed. Ailamazyan E.K., Kulakov V.I., Radzinsky V.E., Savelieva G.M. – 2009.
    2. Ovarian tumors in pregnant women / Bakhidze E.V. / / Journal of Obstetrics and Women’s Diseases – 2011 – T. LX, No. 3.
    3. Tumors and tumor-like formations of the ovaries. Guidelines for doctors / Belskikh O.L., Kuzmenko G.Yu., Klyuchnikova T.N., Kozlova N.F. – 2017.
    4. This article was prepared based on the site materials: https://www.krasotaimedicina.ru/

    IMPORTANT
    The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

    Ovarian cyst: is pregnancy possible? Diagnosis and treatment of ovarian cysts

    Tumors and tumor-like formations of the ovaries are a common diagnosis in the practice of an obstetrician-gynecologist. Depending on their type of such formations, there are various types of therapy. However, everything is not so simple when such a pathology occurs during gestation.

    This article is not to be used for diagnosis, treatment, and is not a substitute for a doctor’s appointment.