Ovarian Cysts During Early Pregnancy: Key Questions Answered

Ovarian teratoma

Dear Dr.
Lu,
My last menstrual period was on September 20.
Since I was trying to conceive, my period did not come in October, so I took a home pregnancy test, which came back positive.
The next day, I went to the obstetrics and gynecology department for an examination.
The doctor performed an ultrasound but did not find an embryo; however, they did detect a tumor on my left ovary, which the doctor estimated to be about 6-7 cm and suggested it looked like a dermoid cyst.
They scheduled another ultrasound in two weeks.

I have the following questions:
1.
Could this be a false pregnancy? Why can't we see the embryo, yet I am experiencing morning sickness?
2.
If I am indeed pregnant, will the tumor affect the fetus or the entire pregnancy?
3.
Are ovarian dermoid cysts mostly benign or malignant? Should it be removed? If so, when would be the appropriate time?
4.
Additionally, I would like to know the sex of the baby.
I heard that a blood test can be done around 8 weeks of pregnancy at my own expense.
How much does it typically cost, and what is the accuracy rate?
Could you please provide me with answers? Thank you!
Sincerely,
A concerned mom

Chou Pi Ma Mi, 30~39 year old female. Ask Date: 2005/10/28

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Could this be a false pregnancy? Why can't we see the embryo yet, but there are symptoms of morning sickness? [The embryo at six weeks is still too small; abdominal ultrasound may not be able to detect it.
A transvaginal ultrasound can be used, and it can usually be seen by five weeks of pregnancy.
If the gestational age is sufficient but it still cannot be seen, the possibility of an ectopic pregnancy should be considered.]
2.
If I am indeed pregnant, will that tumor affect the fetus or the entire pregnancy? [The most common ovarian tumor during pregnancy is a corpus luteum cyst, which generally does not affect the pregnancy.
I am not sure what a "粉瘤" (fen liu) is; please tell me the English term.]
4.
Additionally, if I want to know the sex of the fetus, I heard that a blood test can be done around eight weeks of pregnancy at my own expense.
How much does it cost? What is the accuracy rate? [This type of test is not legal; I apologize for not being able to answer.]
Sincerely, Lu Li-Cheng

Reply Date: 2005/10/28

More Info

Dear Mom-to-be,
Thank you for your detailed inquiry regarding your recent pregnancy and the ovarian cyst identified during your ultrasound. It's understandable to have many questions during this exciting yet uncertain time. Let’s address your concerns one by one.

1. Could this be a false pregnancy? Why can't we see the embryo?
It is unlikely that you are experiencing a false pregnancy, especially since you have had a positive pregnancy test and are experiencing symptoms such as nausea. In early pregnancy, particularly around the time you are at (approximately 4-5 weeks), it is common not to see an embryo on an ultrasound. At this stage, the gestational sac may be visible, but the embryo might not yet be developed enough to be detected. This is often referred to as a "pregnancy of unknown location" until further imaging can confirm the presence of an embryo. It’s important to follow up with your healthcare provider as scheduled to monitor the situation.

2. Will the cyst affect the fetus or the pregnancy?
Most ovarian cysts, especially functional cysts like follicular or corpus luteum cysts, are benign and typically do not affect the pregnancy or the developing fetus. However, larger cysts (like the one you mentioned, measuring 6-7 cm) may require closer monitoring. In some cases, if a cyst is large enough, it could cause discomfort or complications such as torsion (twisting of the ovary) or rupture, which may necessitate surgical intervention. Your healthcare provider will assess the cyst's characteristics and monitor it in subsequent ultrasounds to determine if any action is needed.

3. Are ovarian cysts usually benign or malignant? Should I have it removed?
The majority of ovarian cysts are benign, particularly in younger women. Cysts that are classified as "functional" are typically harmless and resolve on their own. However, the specific type of cyst and its characteristics (such as size, appearance on ultrasound, and any associated symptoms) will guide your doctor’s recommendations. If the cyst appears suspicious or does not resolve, surgical removal may be considered, but this is usually not done until after the first trimester unless there are complications.

4. Can I find out the sex of the baby through blood tests?
Yes, non-invasive prenatal testing (NIPT) can determine the sex of the baby as early as 9-10 weeks of gestation through a blood test. This test analyzes fetal DNA circulating in your blood. The cost can vary widely depending on the provider and location, typically ranging from $100 to $500. The accuracy of these tests is quite high, often exceeding 99% for determining the sex of the baby.

In conclusion, while it is natural to feel anxious about the presence of an ovarian cyst during early pregnancy, most cysts are benign and do not pose a significant risk to your pregnancy. It is crucial to maintain open communication with your healthcare provider, attend all follow-up appointments, and report any concerning symptoms. They will provide you with the best guidance tailored to your specific situation.

Wishing you a healthy and happy pregnancy!
Best regards,
Doctor Q&A Teams

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