FAQs related to ovarian cyst surgery: recurrence and fertility

Ovarian cysts are quite common, and usually, they are harmless. However, sometimes they will need to be removed if they’re causing symptoms of if there are concerns they could be malignant.

We found out some of the answers to your FAQs related to ovarian cyst surgery from Mr Mahantesh Karoshi, a leading London women’s health expert and consultant gynaecologist.
 

I am left with one tube and ovary following torted ovarian cyst surgery, what are my options?

Minority of young women develop benign cysts in their ovaries and some may end of ovarian cyst accident such as torsion requiring emergency removal of the ovary. So, this situation can cause a girl to end up with one tube and ovary.

If this is the case, what options if any to preserve the remaining ovary.
 

What are the chances that a patient will get another cyst that needs treatment?

There is a 40% risk of recurrence. Evidence also shows that the larger the cyst, greater the risk of recurrence.
 

Should I be having regular scans of the remaining ovary to monitor for recurrence?

The answer to this is ‘yes’, but, there is not much scientific evidence based publications as we have in menopausal women with ovarian cysts.
 

Is there an impact on my future fertility now that I only have one ovary left?

In the long term ‘yes’. Several studies have shown that women who had undergone unilateral removal of their ovaries responded less well to ovarian stimulation.

Is there something I can do to completely stop this from happening again?

Oral contraceptive pills are considered to reduce the risk of recurrence of ovarian cysts.

I was told that progestogen only pills can make cysts in the ovary, is this true?

Yes, that’s correct.

What is the best thing I can do to preserve my future fertility?

Freezing of eggs is a good option.
 

To prevent recurrent torsion (not the cysts), patient can undergo laparoscopic shortening of the ovarian ligament

For an evaluation of ovarian cysts or for more guidance related to female reproductive health issues, you may like to book an appointment with a leading consultant gynaecologist such as Mr Mahantesh Karoshi . You can do so via his Top Doctors profile.

Sources

1. BMJ Best practice guidelines
 

2. Bonilla-Musoles F, Ballester MJ, Simon C, et al. Is avoidance of surgery possible in patients with perimenopausal ovarian tumors using transvaginal ultrasound and duplex color Doppler sonography? J Ultrasound Med. 1993 Jan
 

3. Hartley, J., Akhtar, M. and Edi-Osagie, E., 2018. Oophoropexy for recurrent ovarian torsion. Case reports in obstetrics and gynecology, 2018.
 

4.Lass, Amir. (1999). The fertility potential of women with a single ovary. Human reproduction update. 5. 546-50. 10.1093/humupd/5.5.546.
 

5. Cramer, D.W., Xu, H. and Barlow, B.L. (1995) Does ‘incessant’ ovulationincrease risk for early menopause? Am. J. Obstet. Gynecol., 172,568–573.
 

6. MacKenna, A., Fabres, C., Alam, V. and Morales, V., 2000. Clinical management of functional ovarian cysts: a prospective and randomized study. Human reproduction, 15(12), pp.2567-2569.
 

7. Grimes, D.A., Jones, L.B., Lopez, L.M. and Schulz, K.F., 2011. Oral contraceptives for functional ovarian cysts. Cochrane Database of Systematic Reviews, (9).