Managing Ovarian Tumors and Cysts: Fertility Concerns and Options

Teratoma with a cyst: concerns about pregnancy?

Hello, Doctor.
I am 32 years old and have been pregnant once (miscarriage).
Five years ago, I had a 9 cm teratoma on my right ovary, which was treated with laparoscopic surgery.
Six months ago, I became pregnant for the first time, but I miscarried after a month.
During the examination, it was found that the teratoma on the right side had recurred (now 2 cm), and there are also new cysts on the left side (currently two cysts measuring 3 cm and 1-2 cm).
Since I still want to get pregnant, the doctor suggested that I try to conceive quickly and address the cysts later.
However, after trying for six months, I have not been successful in getting pregnant again.

1.
Do the cysts and teratoma affect ovarian function?
2.
Given this situation, would you recommend trying to conceive for another six months? (If unsuccessful after a year, should I then be evaluated for infertility?)
3.
Should I address the cysts first before trying to conceive? But could surgery negatively impact ovarian function?

Hua Hua, 30~39 year old female. Ask Date: 2022/06/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I do not recommend further surgery, and since the tumor is not large, let's try for another six months to see if conception occurs.
Wishing you good health.

Reply Date: 2022/06/30

More Info

Managing ovarian tumors and cysts can be a complex issue, especially when considering fertility. Your situation, involving a history of a teratoma and the presence of chocolate cysts, raises several important points regarding ovarian function and pregnancy.

1. Impact of Ovarian Tumors and Cysts on Ovarian Function: Both teratomas and chocolate cysts (endometriomas) can potentially affect ovarian function. Teratomas, particularly if they are benign, may not significantly impair ovarian function unless they are large or cause complications. However, they can occupy space and potentially disrupt normal ovarian tissue. Chocolate cysts, which are associated with endometriosis, can also affect ovarian function. They may lead to inflammation and scarring, which can impact ovulation and overall fertility. In your case, the presence of both types of cysts may contribute to hormonal imbalances or disrupt the normal ovarian cycle, potentially making it more challenging to conceive.

2. Timing for Trying to Conceive: Given your history of miscarriage and the current state of your ovarian health, it is reasonable to consider whether to continue trying to conceive or to address the cysts first. Many healthcare providers recommend trying to conceive for about six months to a year before pursuing further fertility evaluations, especially if there are no other significant fertility issues identified. However, if you feel that the presence of the cysts is causing discomfort or if you have concerns about their impact on your fertility, it may be prudent to consult with a fertility specialist sooner. They can provide personalized advice based on your specific situation.

3. Surgical Intervention vs. Trying to Conceive: If surgery is recommended to remove the cysts, it is essential to discuss the potential impact on ovarian function with your healthcare provider. While surgery can sometimes improve fertility by removing obstacles to ovulation, it can also carry risks, such as damage to ovarian tissue or reduced ovarian reserve. In many cases, laparoscopic surgery is minimally invasive and can preserve ovarian function, but this is not guaranteed. If you choose to undergo surgery, timing is crucial; many doctors recommend waiting until after a successful pregnancy to minimize risks, but this depends on individual circumstances.

In conclusion, the decision to continue trying to conceive or to address the cysts surgically should be made in consultation with your healthcare provider, ideally a reproductive endocrinologist or a fertility specialist. They can help you weigh the risks and benefits of each option based on your health history, current ovarian function, and personal fertility goals. Additionally, they may recommend further testing to assess your ovarian reserve and overall reproductive health, which can provide more clarity on your chances of conceiving naturally. Remember, every case is unique, and a tailored approach is often the best way to navigate these complex issues.

Similar Q&A

How to Address Infertility with Ovarian Cysts and PCOS

Hello Dr. Chen, I have a few questions I would like to ask you! Recently, during an ultrasound in the obstetrics and gynecology department, I was informed that there is a 5.5x5.1 cm mass on my left ovary. After examination, the doctor diagnosed it as a chocolate cyst, and I also ...

Dr. Chen Changfu reply Obstetrics and Gynecology
If you have been trying to conceive for over a year without success, it is necessary to seek treatment for infertility. There are many potential causes of infertility, and it requires careful diagnosis and treatment. Without knowing the underlying cause of infertility, artificial...

Understanding Ovarian Cysts: Treatment Options and Fertility Concerns

Hello Doctor: Recently, my menstrual period has not arrived, so I went to the gynecology clinic for an examination. An ultrasound revealed a 5 cm cyst on my right ovary. The doctor initially assessed it as benign and suggested further blood tests for ovarian markers. If confirmed...

Dr. Zhan Deqin reply Obstetrics and Gynecology
Your issue may not necessarily be a true cyst. Many so-called cysts are actually fluid-filled sacs formed due to fluid accumulation after menstruation. These types of cysts typically resolve after your menstrual period, so it would be advisable to wait until after your next two m...

Will Ovarian Cysts Recur? Understanding Risks and Fertility Concerns

Hello, doctor. After last year's Spring Festival, I went to the hospital for an examination due to a delayed menstrual period and discovered a 10 cm cyst on my left ovary. I underwent traditional surgery, and it was found that my left ovary had twisted twice, leading to its ...

Dr. Li Guanghan reply Obstetrics and Gynecology
Hello: 1. The likelihood of developing benign tumors in the right ovary is indeed higher than that of the general population, so it is recommended to have an ultrasound examination annually. If a benign tumor recurs, it can be surgically removed before it undergoes torsion, witho...

Managing PCOS: Tips for Women Seeking to Conceive

Hello Dr. Tsao, I was recently diagnosed with polycystic ovary syndrome (PCOS), and both of my ovaries have multiple cysts. However, I really want to have a baby. What methods are available to manage this condition?

Dr. Cao Guotao reply Obstetrics and Gynecology
You have many cystic ovaries, and you can start treatment with ovulation medications. About half of the patients respond well. If the response is poor, you can switch to ovulation injection therapy, which generally has a good response. Of course, if you are overweight, weight los...