Ovarian Cysts: Implications for Ovulation and Fertility

Ovarian cyst?

I have been taking ovulation medication for two months and have seen two different doctors (the original doctor was on leave).
The first ultrasound on day twelve showed six follicles, with the largest measuring 1.5 cm.
The second ultrasound on day ten showed only one follicle, but it measured 2 cm.
My doctor said it is unlikely to be a follicle and could possibly be a cyst, which does not contain an egg.
Is this true? Does this mean there is no ovulation, or is there still a chance for ovulation? Could this cyst lead to infertility? If there are no follicles despite taking ovulation medication, does that indicate ovarian function has declined? I would appreciate your insights, and I apologize for any inconvenience.

jane hung, 30~39 year old female. Ask Date: 2008/07/25

Dr. Cai Yonglong reply Obstetrics and Gynecology

Dear Jane Hung,
1.
In the second cycle of taking ovulation medication, on the tenth day, there was only one follicle observed, measuring 2 cm.
It is likely a cyst, which does not contain an egg, rather than a follicle.
This simply indicates that ovulation did not occur in this cycle, but there is still a chance for ovulation in future cycles.
2.
This cyst will likely resolve on its own over the next few months.
Only in rare cases will it continue to grow and require surgical removal or vaginal aspiration.
Importantly, it will not cause infertility.
3.
You have taken ovulation medication for two consecutive months.
The first month had a good response (with 6 follicles), while the second month had a poor response.
This situation is likely due to the short-term continuous use of ovulation medication leading to a diminished response in the second month, which does not indicate ovarian failure.
It is recommended that you take a break for two to three months before resuming ovulation medication (but you should first have an ultrasound to confirm that the previous cyst has resolved before taking the medication again; otherwise, the cyst may be stimulated and grow larger).
Wishing you good health and all the best!
Sincerely,
Department of Obstetrics and Gynecology, Tainan Hospital, Ministry of Health and Welfare

Reply Date: 2008/07/25

More Info

Understanding ovarian cysts and their implications for ovulation and fertility is crucial for anyone experiencing reproductive health issues. Ovarian cysts are fluid-filled sacs that can form on the ovaries, and they are relatively common among women of reproductive age. While many cysts are benign and resolve on their own, they can sometimes interfere with ovulation and fertility.

In your case, you mentioned taking ovulation medications for two months and undergoing ultrasound examinations that revealed multiple follicles (or cysts) of varying sizes. The presence of these cysts can indicate different things depending on their characteristics. Follicular cysts, which are a normal part of the ovulation process, can develop when a follicle does not release an egg. If the follicle continues to grow, it can become a cyst. The fact that you had six follicles on one ultrasound and only one larger cyst on another suggests that your ovaries are still functioning, but the dynamics of ovulation may be irregular.

Your doctor’s comment about the possibility of the larger cyst being a simple cyst rather than a functional follicle is significant. A cyst that does not contain an egg may not contribute to ovulation, which could explain why you are not achieving pregnancy despite taking ovulation-inducing medications. It is essential to differentiate between functional cysts (which can lead to ovulation) and non-functional cysts (which may not).
Regarding your concerns about whether these cysts could cause infertility, it is important to note that while some cysts can interfere with ovulation, many women with cysts can still conceive. The key factors that influence fertility include the overall health of the ovaries, the presence of regular ovulation, and the condition of the fallopian tubes and uterus. If your cysts are not causing significant hormonal imbalances or physical blockages, they may not be the primary reason for difficulty in conceiving.

As for the concern about ovarian function, the presence of cysts does not necessarily indicate ovarian failure. Ovarian reserve and function can be assessed through various tests, including hormone level evaluations (like FSH, LH, and estradiol) and ultrasound assessments of antral follicle count. If these tests indicate that your ovarian reserve is adequate, it suggests that your ovaries are still capable of producing eggs.

In conclusion, while the presence of ovarian cysts can complicate the process of ovulation and conception, they do not automatically mean that you will be unable to conceive. It is crucial to continue working closely with your healthcare provider to monitor your ovarian health and adjust your treatment plan as necessary. If you have ongoing concerns about your fertility or the nature of your cysts, consider seeking a referral to a fertility specialist who can provide more targeted evaluations and treatment options. Remember, many women with similar challenges go on to have successful pregnancies, so maintaining a hopeful outlook is essential.

Similar Q&A

Does Ovarian Cyst Affect Fertility? Understanding Your Concerns

Hello Dr. Mao, In November of 2003, I visited a gynecologist due to irregular menstruation. After about six months of treatment, my menstrual cycle has returned to normal. However, six months later, I discovered that I had a cyst on my ovary. The doctor mentioned that it is comm...

Dr. Mao Yikun reply Obstetrics and Gynecology
When discovering a cyst, the most important thing is to distinguish whether it is a malignant cyst. If the chance of malignancy is low, outpatient follow-up is sufficient. In pregnant women, the most common type of ovarian cyst found is a functional cyst, which occurs during the ...

Understanding Ovarian Cysts: Impact on Fertility and Commonality Among Women

Q1: Is it true that having cysts on both ovaries can lead to infertility, or is it that having any cysts can cause infertility? Q2: The doctor mentioned that every woman may have these cysts and that they might resolve on their own. Is it true that every woman will experience th...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, a 3 cm small cyst on the ovary can typically be monitored without immediate concern and is likely unrelated to infertility. If you experience any discomfort, it may be advisable to consult a gynecologist. Wishing you good health.

Understanding Ovarian Cysts: Timing and Causes Related to Ovulation

The small cysts on the ovaries that the doctor mentioned are typically related to ovulation. These cysts usually appear during the ovulation phase, which is when the follicle matures and releases an egg. They can also be present just before ovulation as the follicles develop. How...

Dr. Lin Wenbin reply Obstetrics and Gynecology
Ovulation can typically occur before or after the expected time.

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...