A dermoid ovarian cyst is a common type of benign tumor that can form in a woman’s ovaries. Though often harmless, these cysts can have an impact on a woman’s fertility depending on their size, location, and other factors. In this article, we will explore what dermoid ovarian cysts are, how they may affect fertility, and what treatment options are available for women who are concerned about their ability to conceive.
What is a Dermoid Ovarian Cyst?
A dermoid ovarian cyst, also known as a mature cystic teratoma, is a type of benign tumor that develops in the ovaries. It is a cystic growth that contains different types of tissues, such as skin, hair, teeth, and even bones. These cysts are formed from cells that are present at birth and typically grow slowly over time.
Unlike functional ovarian cysts that are related to the menstrual cycle, dermoid cysts are made up of cells from the outer layer of the ovary. They can vary in size, from small and asymptomatic to large and more problematic. The presence of hair, teeth, or fat within these cysts can often be seen on imaging studies, making them distinct from other types of ovarian cysts.
How Do Dermoid Cysts Form?
Dermoid cysts are congenital, meaning they are present from birth. They form when the cells that normally make up the reproductive tissues, such as the ovarian follicles, begin to develop into different tissue types. This can include skin, hair follicles, fat, and even teeth, which are all characteristics of a dermoid cyst.
Though these cysts are typically benign, they can grow large and cause problems. Most women may not even know they have a dermoid cyst because they do not always cause symptoms. However, when symptoms do occur, they may involve abdominal pain, bloating, or changes in the menstrual cycle.
How Do Dermoid Ovarian Cysts Affect Fertility?
The effect of a dermoid cyst on fertility largely depends on its size, location, and whether it causes any complications. In many cases, small dermoid cysts do not affect fertility. However, when the cyst becomes larger or causes certain issues, fertility may be impacted. Let’s explore how these cysts can influence a woman’s ability to conceive.
Impact on Ovarian Reserve
Ovarian reserve refers to the number of viable eggs remaining in a woman’s ovaries. A dermoid cyst, particularly if it grows large or is located in an area of the ovary where eggs are stored, may reduce the ovarian reserve. This could decrease the number of healthy eggs available for fertilization.
Additionally, if a dermoid cyst leads to damage or scarring of the ovarian tissue, it may reduce the ovaries’ ability to produce eggs effectively. This can make it more difficult for a woman to conceive, especially as she gets older.
Disruption of Ovulation
Ovulation is the process during which an egg is released from the ovary, making it available for fertilization. A dermoid cyst can disrupt this process if it is large enough to block the normal functioning of the ovary. The cyst may interfere with the release of eggs or cause hormonal imbalances that affect ovulation. If ovulation does not occur regularly, it may become difficult for a woman to conceive.
Torsion of the Ovary
Another complication associated with dermoid cysts is ovarian torsion. This occurs when the cyst becomes large and causes the ovary to twist. When this happens, blood flow to the ovary is restricted, which can lead to severe pain and potential damage to the ovary. In some cases, ovarian torsion may result in the loss of the ovary or part of it, further compromising fertility.
Risk of Rupture
Dermoid cysts, especially larger ones, are at risk of rupturing. If a dermoid cyst ruptures, it can cause significant pain and lead to the leakage of its contents into the abdominal cavity. This could cause infection or inflammation, which may damage surrounding reproductive organs. Rupture can also disrupt the normal function of the ovaries and fallopian tubes, making it more difficult for sperm to reach the egg or for the fertilized egg to travel to the uterus for implantation.
Formation of Adhesions
In some cases, dermoid cysts may cause adhesions, which are bands of scar tissue that form between the ovary and other organs. Adhesions can interfere with the movement of the fallopian tubes and ovaries, reducing the chances of conception. This can also make it more difficult for an egg to travel to the uterus after ovulation.
Symptoms of Dermoid Ovarian Cysts
Many women with dermoid cysts do not experience symptoms, especially if the cysts are small. However, larger cysts or those that cause complications may present the following symptoms:
Abdominal Pain: Women may experience dull or sharp abdominal pain, especially if the cyst becomes large or is at risk of twisting or rupturing.
Bloating: A large dermoid cyst can cause a feeling of fullness or bloating in the abdomen.
Irregular Menstrual Cycles: Some women may notice changes in their menstrual cycle, such as heavier or more frequent periods.
Pain During Intercourse: If the cyst is pressing on nearby organs, it may cause discomfort or pain during sexual activity.
Nausea and Vomiting: In cases where the cyst causes torsion or rupture, women may experience nausea, vomiting, or severe abdominal pain.
Difficulty Conceiving: Some women may find it difficult to conceive, particularly if the cyst interferes with ovulation or causes damage to the ovaries.
How Are Dermoid Cysts Diagnosed?
Dermoid ovarian cysts are often diagnosed during routine pelvic exams or imaging studies. If a woman is experiencing symptoms or has concerns about fertility, her doctor may recommend further tests to confirm the presence of a dermoid cyst. Common diagnostic methods include:
Ultrasound
An ultrasound is typically the first test used to examine the ovaries and identify cysts. During an ultrasound, sound waves create images of the ovaries, allowing the doctor to determine the size, location, and characteristics of the cyst. Dermoid cysts often have a distinct appearance due to their content, such as hair or teeth, which can be seen on an ultrasound.
CT Scan or MRI
In certain cases, a CT scan or MRI may be used to provide a more detailed view of the cyst, especially if it is large or causing complications. These imaging techniques can help assess the cyst’s relationship to nearby organs and any potential damage.
Laparoscopy
If the diagnosis is unclear or if surgery is required to remove the cyst, a laparoscopy may be performed. During this procedure, a small camera is inserted into the abdomen to visualize the ovaries and determine the size and nature of the cyst. Laparoscopy can also be used to remove the cyst, if necessary.
Treatment Options for Dermoid Ovarian Cysts
The treatment for dermoid cysts largely depends on the size of the cyst, the severity of symptoms, and the impact on fertility. Treatment options include:
Watchful Waiting
If the dermoid cyst is small and does not cause any symptoms, the doctor may recommend a watchful waiting approach. Regular ultrasounds may be performed to monitor the cyst for any changes, and surgery may be considered if the cyst grows larger or causes problems.
Surgical Removal
For larger cysts or those causing symptoms, surgery may be necessary. Ovarian cystectomy is a procedure in which the cyst is removed from the ovary. The goal of this surgery is to preserve the ovary and its function while removing the cyst. In cases where the cyst has caused significant damage to the ovary, an oophorectomy (removal of the ovary) may be necessary, but this is usually avoided when possible to protect fertility.
Fertility Treatment
For women who have difficulty conceiving due to the presence of a dermoid cyst, fertility treatments may be recommended after the cyst is removed. These treatments may include in vitro fertilization (IVF) or other methods that help overcome fertility challenges.
Conclusion
Dermoid ovarian cysts are a relatively common type of benign ovarian tumor. While many women with dermoid cysts do not experience any issues, large cysts or those that cause complications can affect fertility. Dermoid cysts may impact fertility by reducing ovarian reserve, disrupting ovulation, causing ovarian torsion, or leading to adhesions. Diagnosis is typically made through ultrasound or imaging studies, and treatment options depend on the size and symptoms of the cyst. Women who are concerned about fertility and dermoid cysts should consult with a doctor for evaluation and discuss potential treatment options to preserve fertility.
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