ovarian-cyst

Ovarian cysts are very common in women of childbearing years. That is because cysts tend to be triggered by the menstrual cycle and the hormonal changes it causes in the body. There are two ovaries present in a woman each about the size and shape of an almond – one on each side of the uterus. The ovaries produce egg (ovulation) and the female hormones oestrogen and progesterone, and it also regulates the menstrual cycle and pregnancy.

Symptoms of Ovarian Cyst

Ovarian cysts are generally asymptomatic, but in some cases, symptoms may be present. Pain in the abdomen and pelvis is acommon symptom, the other ovarian cyst symptoms include:-

  • Pain during menstruation or intercourse
  • Abdominal bloating or fullness
  • Nausea
  • Vomiting
  • Unusual bleeding
  • Weight gain
  • Inability to empty the bladder completely
  • Breast pain
  • Pain in the pelvis, lower back or thighs
  • And the symptoms that need immediate medical attention are as following-
  • Severe abdominal pain that comes suddenly might be asign of aruptured cyst or atorsion of the cyst.
  • Abdominal pain with vomiting and fever.
  • Fainting
  • Weakness
  • Dizziness
  • Rapid breathing

How does an Ovarian Cyst Form?

An ovarian cyst forms when fluid accumulates within athin membrane inside the ovary. The size of an ovarian cyst can range from as small as apea to larger than an orange, and they are aresult of the menstrual cycle (functional cyst). An egg grows in asac called follicle; this sac is located inside the ovaries, this sac breaks open and releases the egg, when this sac doesn’t break open, the fluid inside the sac or follicle accumulates within athin membrane inside the ovary and forms acyst.

Causes of Ovarian Cyst

  • Some hormones used to treat infertility can cause afunctional cyst to develop in the ovaries.
  • Some breast cancer medicines can cause ovarian cyst, but they disappear once the treatment is over.
  • During pregnancy, ovarian cysts (corpus luteum) forms as there are hormonal changes in the body.
  • Having an underactive thyroid can increase the risk of getting ovarian cyst.
  • Endometriosis can cause ovarian cyst.
  • Smokers have arisk of getting afunctional ovarian cyst.

The Ovarian Cyst Types Include:

  • Functional Cyst Functional cysts are usually harmless, rarely cause any pain and disappear on their own within two or three menstrual cycles. Functional cysts can be of two types

    • Follicular Cyst Around the 14th day of the menstrual cycle (considering 28 days cycle), an egg bursts out of its follicle and travels down the fallopian tube. Afollicular cyst forms when the follicle doesn’t rupture and releases the egg but continues to grow.
    • Corpus Luteum Cyst After the follicle releases the egg, it starts producing oestrogen and progesterone for conception. The follicle now is called acorpus luteum. At times fluid accumulates in the corpus luteum and grows into acyst.
  • Haemorrhagic Cyst is an adnexal mass or lump of tissue-like structure that forms in the ovaries of afemale human body when bleeding occurs into the follicular or corpus luteum. When this happens, the condition is referred to as ahaemorrhagic ovarian cyst.

  • Non-Functional Cysts There are other types of cysts present that are not related to the normal function of the menstrual cycle and can be painful and may need medical emergency, they are as follows-
  • Dermoid Cyst Also called Teratomas because of its abnormal growth can contain tissue, hair, skin or teeth as they are formed from residual embryonic cells. They can cause ovarian torsion, infection, rupture and in rare cases, cancer. Adermoid cyst develops from atotipotential (to grow from asingle cell and produce differentiated cells) germ cell that is retained within the egg sac (ovary). Adermoid cyst may occur at any age, but the prime age of detection is the childbearing years. 15% of women can have them in both ovaries. This cyst can range in size from 1 cm to 45 cm in diameter. The larger the dermoid cyst, the greater the risk of rupture with spillage of the mucinous material which can create aproblem with adhesion, pain. Majority of these tumours are benign, but some 2% can become cancerous.

  • Cystadenomas -Are atype of benign tumour that develops on the surface of the ovary and are filled with awatery or amucous material. It tends to be huge in size. They do not affect the fertility of awoman in their reproductive years, but they do need to be removed.

Classification of aCystadenoma

  • Serous Cystadenoma -They are atype of benign ovarian epithelial tumour accounting for 60% of all serious ovarian tumours. It is found in women within the age range of 40 to 60 years. About 15 -20% of cases are bilateral, and it may be associated with endometriosis. Most tumours are asymptomatic until they reach alarge size. Symptoms include abdominal discomfort, chronic pelvic pain. Some tumours undergo torsion and may cause extreme pain.

  • Mucinous Cystadenoma -They are also benign ovarian tumours, they are considered mucinous (mucous) type based on their appearance under amicroscope. They generally affect women in the age span of 40 to 50 years. It usually presents as asingle mass within the ovary or can occur as multiple masses within asingle ovary; it may affect both the ovaries as well. Symptoms include abdominal pain, vaginal bleeding and increased abdominal size. Complete surgical removal of the tumour is suggested.

  • Endometriomas -Also known as Chocolate Cyst are developed as aresult of acondition in which uterine endometrial cells grow outside the uterus (endometriosis), some of these tissues attaches itself to the ovary and forms agrowth, the area of this endometrial tissue grows and bleeds, as they have no place to shed the tissues and flow out, they form acyst which is filled with blood and red or brown coloured remnants of the tissues.

  • Polycystic Ovaries -Woman suffering from polycystic ovary syndrome have higher than normal levels of the male hormone called androgen. This excess hormone causes multiple small cysts to form in the ovary, and thus the ovaries swell up. Polycystic ovary syndrome causes hair growth on the face and body, can cause baldness too. It can cause long term health problems like diabetes and heart problem. Women suffering from PCOS have irregular or skipped periods and are insulin resistant.

  • Para-Ovarian Cyst -Para means close, and ovarium means ovaries, so as the name suggests, it is acyst near the ovary. They are also called Para-tubal cysts and are epithelium lined fluid-filled cysts in the adnexa adjacent to the fallopian tube. Most cysts are small and asymptomatic, and sizes range from 1cm-8cm in diameter. These cysts are found during surgery or during any imaging examination. Larger cysts can reach asize of more than 20 cm in diameter and then become symptomatic exerting pressure and pain in the lower abdomen.

Complications that can arise from an Ovarian Cyst

During apelvic exam, doctors can find some less common types of cyst. Ovarian cysts that develop after menopause might be cancerous, so it’s important to have regular pelvic examinations. The complications associated with ovarian cysts include-

  • Ovarian Torsion The Cysts that are large can cause the ovary to move out of its original position, increasing the chances of painful twisting of the ovary (ovarian torsion). Symptoms include sudden onset of severe pelvic pain, nausea and vomiting. Ovarian torsion can decrease or stop blood flow to the ovaries, and if not treated, it can cause damage or death of the ovarian tissue.

  • Ruptured Cysts When acyst ruptures, it causes intense pain and internal bleeding. This increases the risk of an infection and can be life-threatening if left untreated.

  • Ovarian Cyst Infection Although ovarian cysts are benign; however, ruptured cysts which is rare, can cause pain and sometimes even lead to ovary bleeding. This complication of ruptured cysts may increase the risk of infection and should not be left untreated.

Diagnosis of Ovarian Cyst

Most of the ovarian cysts do not have any symptoms and go away on their own. If some women have pain or irregular periods, they might visit adoctor.

Some of the ovarian cyst diagnosis options include:

  • Pelvic Examination -A doctor during apelvic exam uses an instrument to widen the vagina, and have alook at the vagina, cervix, uterus, and other reproductive organs to see any changes or lumps.

  • Ultrasound -If he finds any cyst manually, he will order an ultrasound which helps to understand the size, shape, location and composition (solid or fluid-filled) of the cyst.

  • Pregnancy Test -He may also order apregnancy test, apositive test may suggest, that there is apresence of corpus luteum cyst.

  • CA 125 Blood Test -If the cyst is partially solid, and one is at ahigher risk of ovarian cancer, adoctor might order aCA 125 blood test. Blood levels of aprotein called cancer antigen 125 (CA 125) are often elevated in awoman with ovarian cancer. But elevated CA 125 levels are also found in non-cancerous conditions such as endometriosis, uterine fibroids and pelvic inflammatory disease.

  • Other Blood Test -If awoman is under 40, then the doctor might order other blood tests like LDH (lactate dehydrogenase), AFP (alfa- fetoprotein and HCG (human chorionic gonadotropin), these are all tumour markers to check whether the cyst is atype of cancer called the germ cell tumour, though these are very rare.

  • CT Scan -A body imaging device used to create cross-sectional images of internal organs. CT scans do not see small ovarian tumours well, but they can see large tumours and are also able to see if the tumour is growing into nearby structures. It also finds enlarged lymph nodes, can see signs of cancer spread to the liver or other organs or signs if an ovarian tumour is affecting akidney or bladder.

  • MRI -Magnetic resonance imaging, atest that uses magnetic fields to produce in-depth images of internal organs. If adoctor finds the cyst as asolid mass, he might recommend an MRI.

Treatment of Ovarian Cyst

The treatment of an ovarian cyst depends on the age of the patient, the type, size and the symptoms of the cyst. The ovarian cyst treatment plan goes as below-

  • Watchful Waiting -As the majority of cysts disappear after afew weeks or months, adoctor may not immediately recommend atreatment plan. If there is no symptom and an ultrasound report only show asimple small fluid-filled cyst, it is advised to wait and watch and again re-examine if necessary, to see if the cyst has gone on its own.

  • Birth Control Pills -If there is arecurrent ovarian cyst, the doctor may prescribe oral contraceptive pills to stop ovulation and prevent the formation of new cysts.

  • Laparoscopy is aprocedure performed in an operating room, in which adoctor inserts asmall device through an incision in the abdomen. The doctor views the reproductive organs and pelvic cavity using this device. If acyst is seen during this procedure, it will be removed.

  • Laparotomy -If there is alarge cyst, size more than 5cm, the doctor will surgically remove the cyst through alarge incision in the abdomen. Then they will do abiopsy, and if they find the cyst as cancerous, they will do ahysterectomy to remove the ovaries and uterus.

Ovarian Cyst Prevention

Ovarian cysts cannot be prevented; however, aroutine gynaecological examination can detect ovarian cyst early. Most ovarian cysts are benign, but it is important to visit adoctor as symptoms of ovarian cancer are almost similar, to that of an ovarian cyst, so acorrect diagnosis is necessary.

Ovarian Cyst Success Story Medicover Fertility


Neha (32), the name changed on request decided to go the family way after about three years of her marriage.

“After about ayear of trying naturally, Ididn’t conceive. Each time during my menstrual cycle, which was irregular, Ihad severe pain; at times, Ihad bouts of nausea, diarrhoea and constipation. Initially, Ididn’t bother much thinking these symptoms to be associated with my periods. But as Iwas planning to conceive so thought of consulting adoctor. After going through routine gynaecology tests, Iwas detected with alarge cyst on my left ovary, which was advised to be removed. Icould see my dream of becoming amother being shattered. Ihad to go through the cyst removal procedure, and my worst fear came true, the cyst was amalignant one! Before starting chemotherapy and radiation, Iwanted to take an expert opinion from afertility expert and know my chances of becoming amother.

I had heard alot about Medicover Fertility from advertisements as well afriend of mine who had asuccessful IVF treatment there, so Idecided to visit them once. There Ispoke to Dr Sweta Gupta, she saw all my reports and told me not to worry. She told Medicover Fertility uses advanced fertility treatments and believes in fertility preservation of patients suffering from any kind of serious medical issues. She told, she can retrieve eggs from my unaffected ovary and freeze them. Ican still have ababy after my treatment is over. If in any dire consequences, Icannot carry ababy in my womb, Ican opt for surrogacy with my own frozen egg and take home my baby.

And yes, thank you, Dr Sweta Gupta, Ibelieved in you and today after so many hardships Iam amother to abeautiful daughter. Iowe this to Medicover Fertility.”

Doctor’s Suggestion Dr Shweta Gupta (Clinical Director at Medicover Fertility)

As the signs and symptoms of an Ovarian cancer mimic that of an ovarian cyst. We need to be vigilant and need to visit adoctor if something is recurrent and bothering us. For young women with ovarian cancer, it is especially important to consider treatment approaches, that incorporate both ovarian cancer treatment and fertility preservation. For these women, because the ovary is the source of fertility and the site of cancer, the challenge we face is to remove the cancer cells as well as preserve the healthy eggs. The fertility preservation options available to awoman detected with ovarian cancer will depend on age, stage, type and location of the cancer, so it is not only atask of an embryologist but ateamwork of general gynaecologist, gynae-oncologist, operating room staff and reproductive endocrinologists to help the patient preserve the fertility and secure their likelihood of becoming aparent.

Conclusion

The outlook for premenopausal women with ovarian cysts is good. Most cyst disappears within afew months. Recurrent cysts can occur in premenopausal women and in women with hormonal imbalances. If left untreated, some cysts can decrease fertility. This is common with endometriomas and polycystic ovary syndrome. To improve fertility, the doctor removes or gives some hormone injections to down-regulate the activity of acyst. Functional cysts, cystadenomas and dermoid cysts do not affect fertility.

Any cyst or growth that develops on the ovaries after menopause should be removed and examined. This is because the risk of developing acancerous cyst or ovarian cancer increases after menopause. And any cyst that is larger than 5 cm should be removed with aDoctor’s consent.

How can Medicover Fertility help you in Dealing with Ovarian Cyst?

Medicover Fertility is arenowned international brand. We have ateam of highly skilled and experienced doctors who help couple- dealing with infertility and we have ahigh success rate. Medicover Fertility has avery high fertility success rate as we use the latest technology in fertility treatments. Here the couples are carefully examined to find out the actual cause of infertility. There are counsellors to take care of the emotional aspect of apatient.

As we know that all ovarian cysts do not cause infertility. Some cysts tend to go on their own. But some like the polycystic ovary syndrome, endometrioma, and some ovarian tumour might cause infertility. Women need to read the signs and symptoms of their body and need to visit adoctor when asymptom is bothering them. Medicover Fertility successfully treated several patients suffering from Polycystic ovary syndrome, other types of cysts, tumours that affect fertility by retrieving the healthy eggs and if needed, do IVF for those patients.

If you are facing difficulty in conceiving due to Ovarian Cyst, or need an infertility treatment for such issues, you can call us at +917862800700.

Frequently asked questions

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