Most ovarian cysts do not affect fertility. The most common ones are functional cysts, part of the normal menstrual cycle, and they come and go on their own. A few types can make it harder to conceive, mainly endometriomas linked to endometriosis. Even then, many women conceive naturally.
Cysts that do not affect fertility
- Follicular cysts: a follicle that did not release its egg. They usually settle within one to three cycles.
- Corpus luteum cysts: form after ovulation and are common in early pregnancy.
- Dermoid cysts and cystadenomas: these do not stop ovulation. If they need removing because of size or symptoms, surgery aims to keep as much healthy ovary as possible.
Cysts and conditions that can affect fertility
- Endometriomas: cysts caused by endometriosis, sometimes called “chocolate cysts”. Endometriosis can cause inflammation and scarring around the ovaries and tubes, which can lower fertility. Surgery on endometriomas can also reduce the number of eggs in the ovary, so whether to operate should be weighed against your plans for pregnancy.
- PCOS: despite the name, polycystic ovaries contain many small follicles, not true cysts. The fertility problem in PCOS is irregular or absent ovulation, which is usually treatable. Read about PCOS assessment.
Can you get pregnant with an ovarian cyst?
Usually, yes. A functional cyst may delay ovulation in the cycle it appears, but it does not cause lasting infertility, and many women conceive with a simple cyst present.
Does removing a cyst affect fertility?
The aim of surgery is always to remove the cyst and preserve the ovary. Repeated surgery on the same ovary, particularly for endometriomas, can reduce your egg reserve. If you are planning a pregnancy, it is worth checking your ovarian reserve before any operation. A fertility MOT with a blood test and ultrasound can do this.
How cysts are assessed
A pelvic ultrasound, usually transvaginal, shows the type and size of a cyst and whether it looks functional. Functional cysts are often rescanned after six to twelve weeks to confirm they have gone.
When to see a doctor
- You have been trying to conceive for a year without success, or six months if you are 36 or over
- You have endometriosis or a known cyst and are planning a pregnancy
- Your periods have become irregular or very painful
Go to A&E with sudden severe pelvic pain, especially with vomiting or feeling faint. This can mean a cyst has twisted or burst.
Common questions
Do ovarian cysts go away on their own?
Most functional cysts disappear within two or three cycles without treatment.
Can a cyst affect my periods?
Some cysts can cause irregular, delayed or heavier periods.
Does the pill help?
The pill can prevent new functional cysts forming, but it does not shrink a cyst that is already there.
Ovarian cyst assessment in London
Dr Anastasia Mermigka, consultant gynaecologist, can scan and explain your cyst in the same visit. A consultation with pelvic ultrasound is £300 in Central London EC1, with no referral needed. Ovarian cyst assessment.