Ovarian cysts are a common among women during their reproductive years. They are fluid-filled sacs that can form on or within the ovaries, affecting women of all ages. Most ovarian cysts are harmless and often disappear without treatment. However, in some cases, they can cause complications, including infertility. In this article, we explore the relationship between ovarian cysts and fertility problems looking at the types of ovarian cysts that can cause infertility, and the treatment options available.

Understanding Ovarian Cysts

Ovarian cysts are usually detected during routine pelvic exams, or when a woman experiences symptoms such as pelvic pain, bloating, or abnormal bleeding. In most cases, ovarian cysts are benign and require no treatment. However, some can cause complications, such as infertility, if left untreated. Therefore, it is important to understand the different types of ovarian cysts and their potential impact on fertility.

Types of Ovarian Cysts That Can Cause Infertility

There are two types of ovarian cysts: functional cysts and pathological cysts. Functional cysts are usually harmless and are formed during the menstrual cycle. They usually resolve on their own without treatment. Pathological cysts are abnormal growths that require medical intervention. Some pathological cysts that can cause infertility include endometriomas, polycystic ovary syndrome (PCOS), dermoid cysts and cystadenomas.

Functional cysts

Functional ovarian cysts are fluid-filled sacs that develop on the ovaries as a result of the normal menstrual cycle. All women of reproductive age will have a small cyst known as a follicle, during a normal menstrual cycle as this is where eggs develop. Cysts are formed when the follicle that releases an egg during ovulation grows larger than normal and does not rupture to release the egg. Instead, the fluid inside the follicle builds up, forming a cyst. Most functional ovarian cysts are harmless and will resolve on their own without treatment. They typically do not cause any symptoms, but in some cases, they can cause pelvic pain or discomfort. Functional ovarian cysts are the most common type of ovarian cyst and are usually diagnosed during a routine pelvic exam.

Haemorrhagic cyst

A haemorrhagic cyst is a type of functional ovarian cyst that occurs when a blood vessel in the wall of a cyst breaks, causing bleeding into the cyst. These cysts can vary in size and often develop during ovulation when a follicle in the ovary grows and releases an egg.

Haemorrhagic cysts can cause pain or discomfort in the lower abdomen, pelvic region, or lower back. Symptoms may include sudden, severe pain on one side of the pelvis, irregular menstrual cycles, or spotting between periods. Most haemorrhagic cysts are benign and will resolve on their own within a few weeks or months.

However, in some cases, haemorrhagic cysts may require medical treatment, especially if they are causing significant pain or discomfort or if they are large in size. In rare cases, haemorrhagic cysts may lead to complications such as torsion (twisting) of the ovary, rupture, or infection.


Endometriomas are cysts that form as a result of endometriosis, a condition where the tissue that normally lines the inside of the uterus grows outside it, often on the ovaries. These cysts can cause pelvic pain, abnormal bleeding, and infertility. Treatment options for endometriomas may include surgery or hormonal therapy.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects up to 10% of women of reproductive age. It is caused by an imbalance of hormones in the female body, specifically androgens, which are male hormones. Women with PCOS have an excess of androgens that interfere with the production of female hormones, leading to irregular periods, anovulation, and infertility.

The symptoms of PCOS can vary from person to person and may include irregular periods, heavy bleeding, acne, excessive hair growth, weight gain, and difficulty getting pregnant. PCOS can also lead to long-term health problems such as diabetes, high blood pressure, and heart disease.

There is no known cure for PCOS, but there are a variety of treatment options available to manage the symptoms. Lifestyle modifications, such as weight loss and exercise, can be effective in reducing symptoms in some women. Hormonal therapy, such as birth control pills or other medications, may be prescribed to regulate menstrual cycles and reduce androgen levels. Fertility medications can also be used to stimulate ovulation in women who are trying to get pregnant.

Dermoid cysts

Dermoid cysts are a type of ovarian cyst that are made up of tissues such as hair, teeth, and skin. They are usually benign but can grow quite large and cause complications, including infertility. Treatment options for dermoid cysts may include surgical removal of the cyst or the entire ovary, depending on the size and of the cyst.


Cystadenomas are benign tumors that form on the ovaries. While most cystadenomas are harmless, some can grow to a large size and cause complications, including infertility. Treatment options for cystadenomas may include surgical removal of the cyst or the entire ovary, depending on the size and location of the tumor.

Ovarian cancer

Malignant ovarian cysts refer to a rare form of cysts that develop as a result of ovarian cancer. Fortunately these cysts are vary rate and occurs more commonly in older women. If you happen to have ovarian cysts, it is essential to consult your doctor to rule out the possibility of malignancy.


A pelvic ultrasound scan is the most useful test to assess an ovarian cyst. Usually a diagnosis can be made from a single scan. Sometime blood tests are also required to assess ovarian cysts.

The Link Between Ovarian Cysts and Infertility

Ovarian cysts can interfere with fertility in several ways. Large cysts can cause the ovary to twist or become displaced, making it difficult for the egg to travel through the fallopian tube. Additionally, cysts can disrupt the menstrual cycle, leading to irregular periods or anovulation (lack of ovulation). Without ovulation, there is no egg for sperm to fertilize, making conception impossible.

Treatment Options

If an ovarian cyst is causing infertility, treatment options may include surgical removal of the cyst or hormonal therapy to regulate the menstrual cycle. In some cases, fertility medications may also be prescribed to stimulate ovulation. The type of treatment recommended will depend on the size and type of cyst, as well as the individual’s fertility goals.

In some cases, infertility caused by ovarian cysts may require in vitro fertilization (IVF) or other to achieve pregnancy.

Prevention and Conclusion

While it is not always possible to prevent ovarian cysts from forming, there are steps that can be taken to reduce the risk of complications. These include maintaining a healthy weight and avoiding smoking. It is important for women experiencing symptoms of ovarian cysts, such as pelvic pain or abnormal bleeding, to see a doctor promptly to prevent complications.

In conclusion, ovarian cysts can cause infertility by interfering with the menstrual cycle or blocking the passage of the egg through the fallopian tube. Treatment options are available, and prevention measures can be taken to reduce the risk of complications. If you are experiencing symptoms of ovarian cysts, speak with your doctor to determine the best course of action for you. By staying informed and proactive, women can take control of their reproductive health and increase their chances of achieving a healthy pregnancy.

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Matt is an NHS Consultant in Newcastle with over ten years of experience. His PhD research into subfertility and miscarriage involved developing a clinical trial and patient engagement.