How are ovarian cysts detected during pregnancy. What are the potential complications of ovarian cysts in pregnant women. When is surgical intervention necessary for ovarian cysts in pregnancy. How do doctors distinguish between benign and malignant ovarian tumors in pregnant patients. What treatment options are available for ovarian cancer diagnosed during pregnancy. How does pregnancy affect the growth and behavior of ovarian cysts. Are there any risks to the fetus when treating ovarian cysts or cancer during pregnancy.

Understanding Ovarian Cysts and Tumors in Pregnancy

Ovarian cysts and tumors during pregnancy are relatively rare occurrences, with an estimated incidence of 1 in 190 pregnancies. While the vast majority of these growths are benign, understanding their nature, potential risks, and management options is crucial for both healthcare providers and expectant mothers.

Ovarian tumors diagnosed during pregnancy present unique challenges in terms of diagnosis, management, and treatment. The scarcity of randomized controlled trials and cohort studies on this topic has led to limited evidence-based guidelines. However, current data suggests that only 1-6% of ovarian tumors detected during pregnancy are malignant.

Types of Ovarian Growths in Pregnancy

• Simple cysts
• Dermoid cysts
• Endometriomas
• Serous cystadenomas
• Malignant tumors (rare)

Understanding the various types of ovarian growths that can occur during pregnancy is essential for proper management and treatment planning.

Diagnosis and Detection of Ovarian Cysts During Pregnancy

Detecting ovarian cysts during pregnancy often occurs incidentally during routine prenatal ultrasounds. In some cases, women may experience symptoms that prompt further investigation.

Common Signs and Symptoms

• Abdominal or pelvic pain
• Lower back pain
• Bloating or fullness
• Changes in urinary or bowel habits

How are ovarian cysts typically diagnosed during pregnancy? The primary diagnostic tool is ultrasonography, which can provide detailed images of the ovaries and any abnormal growths. In some cases, additional imaging techniques such as MRI may be employed to gather more information about the nature of the cyst or tumor.

Can blood tests help in diagnosing ovarian cysts or tumors during pregnancy? Certain blood markers, such as CA-125, alpha-fetoprotein (AFP), and inhibin A, may be elevated in cases of ovarian malignancies. However, it’s important to note that some of these markers can also be elevated in normal pregnancies, making interpretation challenging.

Management Strategies for Ovarian Cysts in Pregnancy

The management of ovarian cysts during pregnancy depends on various factors, including the size and characteristics of the cyst, gestational age, and the presence of any complications.

Expectant Management

For small, simple cysts (typically less than 6 cm in diameter), expectant management is often the preferred approach. These cysts are usually monitored through regular ultrasounds to ensure they don’t grow significantly or develop concerning features.

Surgical Intervention

When is surgical intervention necessary for ovarian cysts in pregnancy? Surgery may be considered in the following scenarios:

• Cysts larger than 10 cm
• Cysts with solid components or complex features
• Persistent cysts that don’t resolve spontaneously
• Cysts causing severe pain or other complications

The ideal timing for surgical intervention is typically during the second trimester of pregnancy, when the risk of miscarriage is lower and the uterus is not yet large enough to impede access to the ovaries.

Distinguishing Between Benign and Malignant Ovarian Tumors

One of the most critical aspects of managing ovarian growths during pregnancy is differentiating between benign and malignant tumors. This distinction is crucial for determining the appropriate course of treatment and ensuring the best possible outcomes for both mother and baby.

Characteristics Suggesting Malignancy

• Large size (>10 cm)
• Solid or mixed solid-cystic components
• Papillary projections
• Irregular borders
• Increased vascularity
• Presence of ascites

How do doctors distinguish between benign and malignant ovarian tumors in pregnant patients? A combination of imaging studies, tumor marker analysis, and clinical presentation is used to assess the likelihood of malignancy. In some cases, a biopsy may be necessary for definitive diagnosis.

Treatment Options for Ovarian Cancer During Pregnancy

The diagnosis of ovarian cancer during pregnancy presents significant challenges and requires a multidisciplinary approach to care. Treatment decisions must balance the need for timely cancer management with the well-being of the developing fetus.

Surgical Management

Surgery is often the first line of treatment for ovarian cancer, even during pregnancy. The extent of surgery depends on the stage of the cancer and the gestational age.

• Unilateral salpingo-oophorectomy
• Bilateral salpingo-oophorectomy
• Omentectomy
• Lymph node sampling

Chemotherapy

What treatment options are available for ovarian cancer diagnosed during pregnancy? In addition to surgery, chemotherapy may be necessary for more advanced stages of ovarian cancer. While chemotherapy during pregnancy carries risks, it can be administered safely in some cases, particularly after the first trimester.

Are there any risks to the fetus when treating ovarian cancer during pregnancy? The risks associated with chemotherapy during pregnancy include potential fetal malformations, growth restriction, and preterm birth. However, these risks must be weighed against the potential consequences of delaying cancer treatment.

Impact of Pregnancy on Ovarian Cyst Behavior

Pregnancy can have various effects on the growth and behavior of ovarian cysts. Understanding these changes is essential for proper management and decision-making.

Possible Effects of Pregnancy on Ovarian Cysts

• Spontaneous resolution
• Growth or enlargement
• Torsion (twisting of the ovary)
• Rupture
• Hemorrhage within the cyst

How does pregnancy affect the growth and behavior of ovarian cysts? The hormonal changes associated with pregnancy can sometimes lead to the resolution of functional cysts. However, in some cases, cysts may enlarge or develop complications due to the growing uterus and changes in blood flow.

Monitoring and Follow-up of Ovarian Cysts During Pregnancy

Regular monitoring is crucial for ensuring the appropriate management of ovarian cysts throughout pregnancy. The frequency and type of monitoring depend on the characteristics of the cyst and any associated symptoms.

Monitoring Techniques

• Serial ultrasounds
• Tumor marker measurements (in select cases)
• Clinical examinations

What is the recommended follow-up schedule for ovarian cysts during pregnancy? Typically, small, simple cysts are monitored every 4-6 weeks, while larger or more complex cysts may require more frequent evaluations. Any changes in size, appearance, or associated symptoms should prompt reassessment of the management plan.

Long-term Outcomes and Postpartum Management

The management of ovarian cysts and tumors during pregnancy doesn’t end with delivery. Postpartum follow-up and long-term monitoring are essential, particularly for cases involving malignancy or complex benign tumors.

Postpartum Considerations

• Reassessment of cyst size and characteristics
• Completion of staging procedures for cancer cases
• Initiation or continuation of cancer treatment, if necessary
• Long-term surveillance for recurrence

What are the long-term outcomes for women diagnosed with ovarian cysts or cancer during pregnancy? The prognosis largely depends on the nature of the growth and the stage at diagnosis. Many women with benign cysts or early-stage cancers have excellent outcomes, while more advanced malignancies may require ongoing treatment and monitoring.

In conclusion, the management of ovarian cysts and tumors during pregnancy requires a careful balance between maternal and fetal well-being. A multidisciplinary approach, involving obstetricians, gynecologic oncologists, and neonatologists, is crucial for achieving the best possible outcomes. As research in this field continues to evolve, treatment strategies will likely become more refined, offering improved care for pregnant women facing these challenging diagnoses.

Ovarian tumor diagnosed during pregnancy & their management

The incidence of ovarian tumor in pregnancy is quite rare approximating to 1 in 190 pregnancies. Scanty evidence is available for the treatment of this condition due to lack of RCTs and cohort studies. However, only 1-6 % of ovarian tumors are reported to be malignant in nature during pregnancy. We report 6 cases of ovarian malignancies which depicts the difficulty of making this rare diagnosis along with their brief clinical presentation, diagnosis and therapeutic approach. The findings from these cases describe the interventions which ameliorates patients’ quality of life.

• Ovarian tumor is the fifth most common cancer
• Only 3 to 5% of ovarian tumors in pregnancy are malignant.
• Signs and symptoms include incidental finding, abdominal or back pain.
• High levels of Maternal Serum AFP, Inhibin A obtained during aneuploidy screening can be a sign of GCT
• Adequate surgical staging is important for stage I cancer.
• Ideal time for surgery is in second trimester of pregnancy
• Treatment in each case should be individualized
• Chemotherapy can be given antenatally but with prior consents.

A 30-year-old female came at 10 weeks of pregnancy with an 8 cm cyst in left adnexa. On investigation, Ultrasound showed features of a dermoid cyst. Patient was advised to have laparoscopy/ ovarian cystectomy in the second trimester which she refused. However, pregnancy progressed well, and she had to undergo caesarean section at term in view of breech presentation. On CS the cyst was also enucleated and healthy ovarian tissue was preserved. Cut section showed sebaceous material, teeth, bone and hair. On histopathological examination, mature cystic teratoma was reported (Figure 1).

Figure 1: USG depicting mature cystic teratoma in left adnexa

A young multigravida had normal vaginal delivery at term. She was diagnosed to have 10 cm ovarian cyst during antenatal period. 6 hrs after delivery patient complained of severe pain abdomen. Uterus was well contracted. Emergency ultrasound done showed haemorrhage in cyst (Figure 2).

Figure 2: Hemorrhagic cyst

A-30-year-old young primigravida presented with early pregnancy with solid ovarian tumor on one side. Serial ultrasound did not show any increase in the size of tumour. Laparoscopy done and patient underwent one side salpingo-oopherectomy. Other side tube and ovary were normal. Histopathology report suggested serous cyst adenoma with borderline malignancy (Figure 3).

Figure 3: Serous Cyst Adenoma

Elderly primigravida with IVF pregnancy presented with cyst in both ovaries. She was followed up and by 16 wks pregnancy, the cysts had disappeared.

Treated case of endometriosis with infertility underwent LSCS at term. Both ovaries had large cysts. Cystectomy was done. Histopathology report suggested endometriosis.

Young patient with previous history of ovarian cystectomy (simple cyst) presented at 14 weeks pregnancy with ovarian cyst of size 8-10cm. It was increasing in size, so she underwent laparoscopy with removal of intact ovarian cyst at 20 weeks pregnancy. Histopathology report suggested serous cyst adenocarcinoma. She was followed up and at 34 weeks underwent LSCS with staging laparotomy. She wanted her uterus to be preserved. Omentum lymph node and other ovary were found negative for malignancy. For last 7 years, she is under follow up and is doing well.

Ovarian Dermoid cysts <6 cm is not expected to grow during pregnancy or to cause complications in pregnancy and labor. 50 percent of Epithelial Ovarian Cancer (EOC) is detected during pregnancy (Low Malignant Potential) and rest 50% is invasive in character. Germ Cell Tumor comprises of 75% dysgerminoma, 25% EST, immature teratoma and mixed. Most of the GCT is unilateral. 10-15% dysgerminoma are bilateral. Sex cords tumors include 50% granulosa cell tumor, 35% sertoli leydig cell tumor and rest 15% are unclassified or stromal. Asymptomatic masses >10cm present after 1^st trimester or tumors which are solid or having solid and cystic areas/ papillary are usually malignant. Resection is the line of treatment in case of a malignant malignancy. For Benign looking tumors, expectant management is preferred [1]. Diagnosis can be made by appropriate history recording, sonological features, resecting the ovarian neoplasm and Biopsy. The Clinical features of neoplasm include Asymptomatic/ nonspecific symptoms, V/E in early pregnancy, acute pain, and unexplained elevated markers during antenatal screening. Markers like CA 125 are unlikely to be markedly elevated solely because of pregnancy. Range between 1000- 10,000 likely but not always related to cancer and 75-150 could be either pregnancy related. AFP normally rises during pregnancy. AFP levels associated with ovarian cancer can be much higher MOMs. LDH is not increased in normal pregnancy but increases in patients with HELLP, Pre-eclampsia and in women with dysgerminoma. HCG cannot be used due to its physiologic increase in pregnancy. Inhibin A is made in developing placenta. All antigens studied, except CA 153, are oncofetal. The presence of considerable concentrations of AFP, hCG, CEA, CA125, SCC, MCA, TPS, CA 199, and PSA in AF during pregnancy may be attributed to their involvement in biological functions associated with fetal development, differentiation, and maturation. MS CEA, CA 153, and CA 199, in contrast to all the others, are not influenced significantly by pregnancy and thus remain reliabletumor markersin monitoring malignancy in pregnant patients [2]. Familiarity with the clinicopathologic and sonographic features of common and uncommon adnexal masses in pregnancy is important for diagnosis and treatment [3]. Surgical intervention must be done after first trimester and became functioning ovarian cysts resolve; drug induced teratogenesis is reduced, NT scan rules out aneuploidy, Corpus Luteum function has been replaced by placenta by this period of gestation Rise in the frequency of adnexal masses exposed during pregnancy concurrently occurs with the prenatal ultrasound adoption. However, majority of such masses may resolve by second trimester. Unrelenting masses poses a great risk for episodes like torsion, rupture and obstruction of labour. These events may lead to emergency surgical intervention with elevated risk for unfavourable outcome for mother and the fetus. Additionally, a small risk of cancer still prevails and therefore, prolong delay in the diagnosis must be avoided. Surgical resection of constant adnexal mass should be done at approximately 16 to 20 weeks of gestation. In 5% malignant cases of adnexal masses, accurate staging must be done. However, in certain cases chemotherapy can be initiated [4]

If a malignancy is suspected, surgical intervention via midline vertical incision is the choice. Laparoscopy is recommended in the case of Low Malignancy Potential. In case of a malignancy, surgical staging assess other ovary. If pregnancy is desired, hysterectomy should not be performed. If the diagnosed malignancy is ovarian cancer, then cytoreduction is attempted. Choice of treatment for women diagnosed with advanced stage ovarian cancer before delivery is radical surgery. Avoid lymph node dissection in case of Germ cell tumor such as Endodermal sinus tumor. Widespread usage of ultrasonography in early pregnancy phase has helped the identification of incidental adnexal masses more frequent. Although, high resolution ultrasound has made observation, a practical option. Surgical treatment is warranted at risk of clinically symptomatic, torsion, or rupture masses suspected for malignancy. In well-equipped tertiary care centers, laparoscopy has depicted success in pregnancy and is safe in experienced hands and equipped armamentarium [5]. FIGO stage III endometrioid ovarian carcinoma diagnosed during 22 weeks of pregnancy was treated with chemotherapy while preserving the pregnancy [6]. During pregnancy, chemotherapy must be considered in second trimester if a diagnosis of epithelial ovarian cancer is made. However, cancer of ovary during pregnancy is uncommon. Majority of chemotherapy sessions are administered in combination with cisplatinum. However, scanty evidence is available regarding the use of Paclitaxel with carboplatin during pregnancy and no adverse episode has been reported in the fetus [7]. Since scanty evidence is available regarding the best possible therapeutic approach to epithelial ovarian cancer during pregnancy. Individual approach must be addressed for different cases. In this rare and challenging situation, treatment in tertiary care centre must be intended [8,9]. Adnexal mass during caesarean delivery poses a positive favourable prognosis in terms of maternal and fetal outcomes [10]. Serous neoplasm of low malignant potential depicts aggressive microscopic and clinical features during pregnancy. However, the features appear to revert back in case of pregnancy termination [11]. After 7^th week of gestation, ovarian tumors > 10cm diameter or having a teratoma component can be resected to avoid complications. This indirectly reduces the risk for malignancy and emergency surgery. No concrete evidence is suggestive of fetal loss risk during 7^th week of gestation [12]. Conservative Management is the line of management employed for the optimal management of ovarian tumors in pregnancy [13].

Ovarian tumor is the fifth most common cancer diagnosed during pregnancy after breast, thyroid, cervical and Hodgkin’s disease. This tumor can be categorized into two types as Benign and Malignant. Examples of benign entities include simple cyst, theca luteal cyst and luteoma. 1-6% adnexal masses detected during pregnancy are malignant. Only 3 to 5% of ovarian tumors in pregnancy are malignant. However, majority of the complicating tumors in pregnancy are either borderline or malignant in nature. Signs and symptoms include incidental finding, abdominal or back pain. High levels of Maternal Serum AFP, Inhibin A obtained during aneuploidy screening can be a sign of GCT. Surgical resection is suggested rather than expectant management of asymptomatic masses present after first trimester that are >10cm or have solid/ papillary area. Adequate surgical staging is important for stage I cancer. Ideal time for surgery is in second trimester of pregnancy Treatment in each case should be individualized. Chemotherapy can be given antenatally but with prior consents. Prognosis in patients detected with ovarian tumors in pregnancy is good.

• 1. Caspi B, Levi R, Appelman Z, Rabinerson D, Goldman G, et al. (2000) Conservative management of ovarian cystic teratoma during pregnancy and labor. Am J Obstet Gynecol 182: 503-505. [Crossref]
• 2. Sarandakou A, Protonotariou E, Rizos D (2007) Tumor markers in biolog ical fluids associated with pregnancy. Crit Rev Clin Lab Sci 44: 151-178. [Crossref]
• 3. Chiang G, Levine D (2004) Imaging of adnexal masses in pregnancy. J Ultrasound Med 23: 805-819. [Crossref]
• 4. Giuntoli RL 2nd, Vang RS, Bristow RE (2006).Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol 49: 492-505. [Crossref]
• 5. Yakasai IA, Bappa LA (2012) Diagnosis and management of adnexal masses in pregnancy. J Surg Tech Case Rep 4: 79-85. [Crossref]
• 6. Picone O, Lhommé C, Tournaire M, Pautier P, Camatte S, et al. (2004) Preservation of pregnancy in a patient with a stage IIIB ovarian epithelial carcinoma diagnosed at 22 weeks of gestation and treated with initial chemotherapy: case report and literature review. Gynecol Oncol 94: 600-604. [Crossref]
• 7. Méndez LE, Mueller A, Salom E, González-Quintero VH (2003) Paclitaxel and carboplatin chemotherapy administered during pregnancy for advanced epithelial ovarian cancer. Obstet Gynecol 102: 1200-1202. [Crossref]
• 8. Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, et al. (2009) Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertil Steril 91: 1895-1902. [Crossref]
• 9. Grimm D, Woelber L, Trillsch F, Keller-v Amsberg G, Mahner S (2014) Clinical management of epithelial ovarian cancer during pregnancy. Eur J Cancer 50: 963-971. [Crossref]
• 10. Baser E, Erkilinc S, Esin S, Togrul C, Biberoglu E, et al. (2013) Adnexal masses encountered during cesarean delivery. Int J Gynaecol Obstet 123: 124-126. [Crossref]
• 11. Mooney J, Silva E, Tornos C, Gershenson D (1997) Unusual features of serous neoplasms of low malignant potential during pregnancy. Gynecol Oncol 65: 30-35. [Crossref]
• 12. Wang PH, Chao HT, Yuan CC, Lee WL, Chao KC, et al. (1999) Ovarian tumors complicating pregnancy. Emergency and elective surgery. J Reprod Med 44: 279-287. [Crossref]
• 13.Lee GS, Hur SY, Shin JC, Kim SP, Kim SJ (2004) Elective vs. conservative management of ovarian tumors in pregnancy. Int J Gynaecol Obstet 85: 250-254. [Crossref]

Editorial Information

Editor-in-Chief

Hiroshi Miyamoto
University of Rochester Medical Center

Article Type

Case Series

Publication history

Received: May 25, 2020
Accepted: June 16, 2020
Published: June 19, 2020

Copyright

©2020 Khullar H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Khullar H, Mediratta G, Garg S (2020) Ovarian tumor diagnosed during pregnancy & their management. Integr Cancer Sci Therap 7: DOI: 10.15761/ICST.1000338.

Figure 1: USG depicting mature cystic teratoma in left adnexa

Figure 2: Hemorrhagic cyst

Figure 3: Serous Cyst Adenoma

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.

Ovarian cyst: symptoms, treatment, diagnosis

An ovarian cyst is a common occurrence in reproductive age, but it is relatively harmless: only a fraction of ovarian cysts require surgical treatment. From this material, you will learn what an ovarian cyst is, why it occurs, what types of cysts are found, and what to do if a woman has been diagnosed with this.

What is an ovarian cyst

An ovarian cyst is a tumor-like formation. Simply put, it is a capsule filled with liquid. Most cysts do not become malignant and are functional, which means they go away on their own. Unlike tumors, a cyst does not grow into organs, does not metastasize, and does not produce hormones. Functional cysts are found only in girls and women of reproductive age.

The etiology of ovarian cysts is unknown. Among the probable causes, hormonal failure and inflammatory processes in the pelvic organs are noted.

How an ovarian cyst is detected

This problem is dealt with by a gynecologist. He finds out the anamnesis and finds out what complaints the patient is worried about. With an ovarian cyst, a woman may be disturbed by a pulling pain in the lower abdomen that occurs during intercourse, active exercise, or even at rest. For some women, pain appears a few days before menstruation or in the first days of the cycle.

The next step is a gynecological examination. The doctor determines the location of the cyst, its mobility, consistency, size and tenderness2. After that, he directs the woman to a gynecological ultrasound.

Pelvic ultrasound is performed with two probes: transabdominal and transvaginal. The specialist examines the pelvic cavity, ovaries and the formation itself, making a conclusion about its size and structure. Ultrasound must be done several times: if 4-6 weeks after the first ultrasound the cyst has increased, then the doctor assumes a tumor and prescribes additional studies.

What are the types of ovarian cysts

All tumor-like formations of the ovaries, depending on the structure and symptoms, can be divided into several types:

• Follicular cyst. Such an education most often develops in young women, more often manifesting itself as menstrual irregularities. The follicular cyst is unilateral, mobile, painless, elastic consistency, up to 6 cm in diameter. The follicular cyst can go away on its own in 3-6 months.
• Cyst of the corpus luteum. This is a cyst that has arisen from the corpus luteum of the ovary after ovulation. It manifests itself as a delay in menstruation, engorgement of the mammary glands and scanty blood discharge. A corpus luteum cyst is dangerous to rupture – especially during intercourse.
• Simple (serous) ovarian cyst. It is often asymptomatic and is an incidental finding on ultrasound. With large sizes, pulling pains in the lower abdomen are possible.

Sometimes an ovarian cyst is referred to as an endometrioid cyst. It is not right. According to the classification, the endometrioid cyst belongs to another group – benign ovarian tumors. The tactics of a doctor when an endometriotic cyst is detected differs from that for other ovarian cysts.

How is an ovarian cyst treated

In most cases, the doctor decides to observe the ovarian cyst: he invites the woman for a second examination and ultrasound in a few weeks. The cyst can pass on its own in 2-3 menstrual cycles.

An ovarian cyst can be removed, but this requires indications: rupture, suppuration of the cyst, or torsion of its legs. Surgery is also needed when the ovarian cyst is too large and interferes with daily activities. The cyst is removed both in the standard way and laparoscopically – through small holes in the abdominal wall.

Folk remedies and dietary supplements for ovarian cysts have no proven effectiveness, and in case of complications they can even be harmful. With discomfort, painful menstruation and heaviness in the lower abdomen, it is more rational to make an appointment with a gynecologist and not self-medicate.

Where to go for help

You can make an appointment with a gynecologist at the Embryo Reproduction Clinic. You will be assisted by a specialist with a proven education and clinical experience of at least 10 years. We strictly follow the principles of evidence-based medicine and medical ethics, striving to help a person, and not just cure a diagnosis. Call by phone or leave a request on the site.

References:

Ovarian cyst treatment in Krasnodar

• General
• Causes
• Symptoms
• When a doctor is needed
• Diagnosis of ovarian cysts
• Treatment of ovarian cysts in Zdrava clinic

Cyst The ovary is a fluid-filled sac or cavity in or on the surface of the ovary. Women have two ovaries (each about the size and shape of an almond seed) on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released from the ovaries on a monthly basis throughout a woman’s childbearing years.

Many women sometimes develop ovarian cysts. Most ovarian cysts cause little to no discomfort and are harmless. Many of them disappear without treatment within a few months.

However, ovarian cysts – especially those that have ruptured – can cause serious problems. To protect your health, get regular pelvic exams and learn to recognize symptoms that could signal a potentially serious problem.

Most ovarian cysts develop as a result of a woman’s menstrual cycle (functional cysts). Other types of cysts are much less common.

Functional ovarian cysts

Cyst-like structures called follicles usually appear monthly on the ovaries. The follicles produce the hormones estrogen and progesterone and release an egg at ovulation.

If a normal follicle continues to grow after the ovulation period, it is known in medicine as a functional cyst.

Science identifies two types of functional cysts

• Follicular cyst. Around the middle of the menstrual cycle, the egg is released from the follicle and travels down the fallopian tube. A follicular cyst occurs when a follicle does not rupture and release an egg, but continues to grow.
• Cyst of the corpus luteum of the ovary. When the follicle releases an egg, it starts producing estrogen and progesterone for conception. This follicle is now called the corpus luteum. Sometimes fluid builds up inside the follicle, causing the corpus luteum to turn into a cyst.

Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

Types of cysts not related to the normal function of the menstrual cycle:

• Dermoid cysts. Also called teratomas, they may contain tissue such as hair, skin, or teeth because they form from embryonic cells. They are rarely cancerous.
• Cystoadenomas. They develop on the surface of the ovary and may be filled with watery or mucous material.
• Endometrioid ovarian cyst. It develops as a result of a condition in which uterine endometrial cells grow outside of your uterus (endometriosis). Some tissues can attach to the ovary and cause the cyst to grow.

Dermoid cysts and cystadenomas can become large causing displacement of the ovary. This increases the likelihood of painful twisting of the ovary, which is called ovarian torsion. Torsion of the ovaries can also lead to a decrease or cessation of blood flow in it.

Risk factors.

The risk of developing an ovarian cyst increases if a woman has:

• Hormonal problems. This includes taking the fertility drug clomiphene (Clomid), which is used to make you ovulate.
• Pregnancy. Sometimes a cyst that forms during ovulation remains in the ovary throughout pregnancy.
• endometriosis. This is a condition in which endometrial cells grow outside of your uterus. Some tissues can attach to the ovary and cause an endometrial cyst.
• Severe pelvic infection. If the infection spreads to the ovaries, it can cause cysts to form.
• Previously transferred ovarian cyst. If you have had a cyst, there is a chance that this situation will recur.

Complications of ovarian cysts

Some women develop less common types of cysts that a doctor finds on a pelvic exam. Cystic ovarian masses that develop after menopause can be malignant. That’s why it’s so important to get regular pelvic exams.

Uncommon complications associated with ovarian cysts:

• Volvulus of the ovaries. Cysts that enlarge can cause the ovary to move, increasing the chance of painful ovarian torsion (ovarian torsion). Symptoms may include sudden onset of severe pelvic pain, nausea, and vomiting. Ovarian volvulus can also reduce or stop blood flow to the ovaries.
• Rupture of the cyst. This condition can cause severe pain and internal bleeding. The larger the cyst, the greater the risk of rupture. Active activities that affect the pelvic organs, such as vaginal intercourse, also increase the risk.

Most cysts cause no symptoms and go away on their own.

However, a large ovarian cyst can cause:

• Pain in the pelvic area. Dull or sharp pain in the lower abdomen from the side of the cyst.
• Feeling of heaviness in the abdomen.
• Bloating.
• Sudden, severe pain in the abdomen or pelvis.
• Pain accompanied by fever or vomiting.

If you have these signs and symptoms or symptoms of shock – cold, clammy skin; rapid breathing; confusion or weakness – see a doctor immediately!

An ovarian cyst may be found during a routine gynecological examination. Depending on its size and whether it is fluid-filled, solid, or mixed, your doctor will likely recommend tests to determine its type and whether it needs treatment.

Possible tests to determine the type of ovarian cyst

• Pregnancy test. A positive test may indicate that you have a corpus luteum cyst.
• Ultrasound of the pelvic organs. A wand-type device (transducer) sends and receives high-frequency sound waves (ultrasound) to create an image of your uterus and ovaries on a video screen. Your doctor analyzes the image to confirm the presence of a cyst, help determine its size and location, and determine if it is a solid, fluid-filled, or mixed.
• Laparoscopy. Using a laparoscope—a thin, lighted instrument inserted through a small incision into your abdomen—your doctor can see your ovaries and remove an ovarian cyst. This is a surgical procedure that requires anesthesia.
• CA 125 blood test. Blood levels of a protein called cancer antigen 125 (CA 125) are often elevated in women with ovarian cancer. If your cyst is partially hard and you are at high risk for ovarian cancer, your doctor may order this test.

Elevated levels of CA 125 can also occur in non-neoplastic conditions such as endometriosis, uterine fibroids, and pelvic inflammatory disease.

Treatment of ovarian cysts in Krasnodar in our clinic is carried out using various tactics. Treatment for ovarian cysts depends on your age, the type and size of your cyst, and your symptoms.

Possible tactics in the treatment of ovarian cysts:

• Observation by a doctor for several menstrual cycles. In many cases, you can wait and get re-examined to see if the cyst goes away within a few months. This is usually an option, regardless of your age, if you are asymptomatic and an ultrasound shows that you have a simple, small, fluid-filled cyst. Your doctor will likely recommend that you periodically undergo a pelvic ultrasound during this period to determine the presence and size of your cyst.
• Medical treatment. Your doctor may recommend hormonal birth control, such as birth control pills, to help prevent ovarian cysts from coming back. However, birth control pills will not shrink an already existing cyst.
• Surgical removal of the cyst. Your doctor may suggest removing a large cyst that doesn’t look like a functional cyst, has been growing for two or three menstrual cycles, or is causing you pain and discomfort.

Some cysts can be removed without removing the ovary (ovarian cystectomy).