A continually growing cyst in a woman who has been on oral contraceptives for at least several months should be investigated to rule out tumor. Because women on oral contraceptives should not ovulate, they should not develop functional cysts, therefore we’re going to be looking at other types of cysts – the endometriomas, the cystadenomas, the dermoid cysts, occasionally polycystic ovaries, and rarely the cancerous cysts.
Another thing, intrauterine devices, so things like Marina by Berlex, the old Copper Sevens, various intrauterine devices which are pieces of plastic, plastic and metal, plastic and metal secreting hormone, put into the uterus which through a complex mechanism causes no – basically causes no conception. And these are not – and I repeat are not associated with any increase in cysts, any increase in tumors. There absolutely is – it’s a non-event. Some women have a problem with intrauterine devices causing pain, and I don’t doubt that.
I’ve had to remove many of them, because the uterus contracts and it can cause pain. It doesn’t have to be right in the middle, can cause a right side, left side, but it is not causing a pathologic problem, something that’s going to develop into something. I’ve noticed some of your questions here, and I think some of these are important to hit on as part of this. And one question by one of your listeners was, am I able to have children if I have ovarian cysts? Absolutely, there’s no decrease in fertility if you have a diagnosis of ovarian cysts. The only case would be again, the endometriomas which are going to be – which is endometriosis in the wrong place if it’s associated with infertility. We can treat that, we can treat it with medication, reverse that process, and start the ovulation. The other case would be polycystic ovaries. These are not usually large cysts, but again the polycystic ovaries are associated with infertility. Again, treatable, and in fact in cases where just diet is not going to reverse if there are certain drugs that can cause ovulation, or you can take Clomiphene, Clomid, it causes one to ovulate.
It can break that vicious cycle of not ovulating, and oftentimes it’s very effective. Pregnancy usually does occur, and in rare cases there are certain surgical procedures on the ovary, very simple, that can stop the polycystic ovary disease symptom of not having periods. So that’s reversible. So how hard is it to get pregnant with a cyst? It’s easy. I mean you better have a cyst or you probably are pregnant because you’re going to have to have a follicular cyst, although you might not see it.
A large cyst, some of these other cysts as we said can prevent pregnancy, but once they’re removed or taken care of, it’s not going to affect fertility, it’s not going to affect a pregnancy outcome. You can have normal periods after a cyst. The only time your periods are usually abnormal is with endometriomas or polycystic ovary disease which we’ve talked about, and can be rectified. One woman notes that she had a cyst on her left ovary and she’s 12 weeks pregnant, and wanted to know if this will affect the unborn child.
Dr Christopher Freville ponders upon the question – she has given us a little bit of information. We already know from our discussion, what have we learned today, that cysts on an ovary are common. In fact they’re often necessary because the corpus luteum cyst of pregnancy is a functioning cyst necessary for the pregnancy and will not affect the unborn child at all. If it was a cyst – and sometimes I might add that cysts show up during pregnancy that don’t go away. What do we do about those? Well, we have a large cyst that shows up on exam, or shows up on ultrasound that does not go away, then it is mandatory that this woman have operative intervention, have a laparotomy.
Laparotomies do not cause an increase in miscarriages, do not cause an increase – any child birth defects. It’s just unfortunate complication unrelated to the pregnancy, but just as women are going to develop any of these cysts, women pregnant can develop any of these cysts. When they’re found they need to be taken care of because the persistent cysts during pregnancy – during delivery could cause a problem with the delivery, and we don’t want that. So as soon as you find out something during pregnancy we take care of it.