Do ovarian cysts really cause infertility? A doctor busts the myths

After being diagnosed with an ovarian cyst, Vicky Pattisonhas spoken out about her fears she’ll never have a baby. The 34 year old formerGeordie Shorestar andI’m A Celebrity… Get Me Out Of Here! winner was diagnosed with a cyst on her ovary after experiencing painful periods last year.

The star then admitted she became 'fixated' on her chances to have children with boyfriend, Ercan Ramadan, and evenrevealed her plans to freeze her eggs– but what are ovarian cysts, and do they really affect women’s fertility?

OK! spoke exclusively spoke to Consultant Dr Charlotte Cassis, who specialises in Obstetrics and Gynaecology, to bust some of the myths surrounding this very common condition.

“An ovarian cyst is a fluid-filled sac that develops on an ovary – they're very common and are usually diagnosed on ultrasound. In most cases they are nothing to worry about,” explains Dr Cassis. “They often don't cause any symptoms and most simple small ovarian cysts occur naturally and go away in a few months without needing any treatment.”

What do ovaries actually do?

The ovaries are two almond-shaped organs that are part of the female reproductive system. There's one on each side of the womb (uterus). And they have two main functions:

  • to release an egg approximately every 28 days as part of the menstrual cycle

  • to release the sex hormones oestrogen and progesterone, which play an important role in reproduction

Ovarian cysts may affect both ovaries at the same time, or they may only affect one.

Symptoms of an ovarian cyst

The two main types of ovarian cyst are “functional ovarian cysts” which are cysts that develop as part of the menstrual cycle and are usually harmless and short-lived; these are the most common type, and “pathological ovarian cysts” which form as a result of abnormal cell growth; these are much less common.

An ovarian cyst usually only causes symptoms if it splits (ruptures), is very large or blocks the blood supply to the ovaries.

In these cases, you may have:

  • pelvic pain– this can range from a dull, heavy sensation to a sudden, severe and sharp pain

  • pain during sex

  • difficulty emptying your bowels

  • a frequent need to urinate

  • heavy periods ,irregular periodsor lighter periods than normal

  • bloating and a swollen tummy

  • feeling very full after only eating a little

  • difficulty getting pregnant – although fertility is usually unaffected by ovarian cysts

Are some people more susceptible to getting cysts?

“A small cyst will form every month in women who ovulate,” says Dr Cassis. “So because of this yes, cysts are more common in women of child bearing age. But it’s not something that particularly runs in families.

If you are postmenopausal, there is a slightly higher risk ofovarian cancer. “Post menopausal women would need more investigation and a follow up would be recommended to monitor the cyst,” she says.

How common is it to require surgery to remove them?

“Up to 10% of women will have some form of surgery in their lifetime for an ovarian cysts nor an ovarian mass,” says Dr Cassis. “In premenopausal women, almost all cysts are benign, that is harmless, with only a one in 1000 risk of malignancy.

Does having a cyst make you less fertile?

“Cysts don't usually affect fertility, as functional monthly cysts actually suggest ovulation is happening in your body. Functional cysts under 5cm usually go away by themselves and don’t need an operation,” reassures the doctor.

“But they can cause pain, and if they grow big, they carry the risk of torting – which means the ovary can twist on it’s stem – which could then block blood supply and then in extreme circumstances can result in losing the ovary.

“For a cyst over 7cm, or if the woman is experiencing symptoms, we would recommend an operation due to this risk of torting, Ovarian cysts can in some cases be huge, and grow up to 20cm."

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If you need an operation to remove your cysts, your surgeon will aim to preserve your fertility whenever possible. This may mean removing just the cyst and leaving the ovaries intact, or only removing one ovary. In some cases, surgery to remove both your ovaries may be necessary, in which case you'll no longer produce any eggs.

Make sure you talk to your surgeon about the potential effects on your fertility before your operation.

“The only ones that potentially hinder your chances of conceiving are endometriomas, as they are associated with endometriosis which can affect fertility," Dr Cassis continues.

Ovarian cysts can sometimes also be caused by an underlying condition, such asendometriosis.

“Don’t confuse ovarian cysts with polycystic ovary syndrome (PCOS),” she says. “This is a different condition, with different outcome and requiring different treatment – but the name can mislead people.” For more on PCOSread here.

What if you discover you have them when already pregnant?

“This would usually not be an issue, so please don’t worry,” says Dr Cassis. "They can usually be managed conservatively and followed up after pregnancy.”

Should we all be freezing our eggs?

“I wouldn’t advise most women rush out and have their eggs frozen,” warns Dr Cassis.

“Vicky Pattison might have other reasons for choosing to do this, which is fair enough. But generally speaking, egg freezing doesn't always have a great success rate, freezing embryos can be a better option for some couples.

“People do choose to freeze eggs for fertility reason, and if you have the financial resources to do it, that’s an option. But it’s expensive and its success rate depends on a number of different factors. It would be misleading for women to freeze their eggs for fertility purposes believing they can then safely delay having children until they’re 50.”

See a GP if you have symptoms of an ovarian cyst. If a GP thinks you may have an ovarian cyst, you'll probably be referred for anultrasound scan, carried out by using a probe placed inside your vagina.

If you have sudden, severe pelvic pain you should immediately contact either:

  • a GP or local out-of-hours service

  • NHS 111

  • your nearest A&E

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