What Should You Know About Fertility-Sparing Surgeries for Ovarian Cysts?

Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. While many cysts are harmless and resolve on their own, some can lead to complications such as pain, hormonal imbalances, or even fertility issues. For women who wish to conceive in the future, fertility-sparing surgeries offer a solution to remove problematic cysts while preserving ovarian function. With advancements in minimally invasive techniques like laparoscopic cystectomy and endometriosis surgery, fertility outcomes have significantly improved.

What Are Ovarian Cysts?

Ovarian cysts are common in women of reproductive age, often forming as a natural part of the menstrual cycle. However, some cysts may require medical attention due to their impact on fertility and overall health.

Common Types of Ovarian Cysts

1. Functional Cysts – Form during ovulation and usually resolve without treatment.
2. Dermoid Cysts – Contain tissue like hair or fat and may require surgical removal.
3. Endometriomas (Chocolate Cysts) – Linked to endometriosis and can affect fertility.
4. Polycystic Ovaries (PCOS-Related Cysts) – Multiple small cysts that disrupt ovulation.

Symptoms and Potential Complications

• Irregular menstrual cycles
• Pelvic pain or bloating
• Pain during intercourse
• Difficulty conceiving
• Rupture or torsion (twisting) of the ovary, requiring emergency care

Diagnostic Procedures

• Ultrasound Scan – Identifies the size, type, and location of the cyst.
• Blood Tests (CA-125) – Helps detect ovarian cancer risk in postmenopausal women.
• Laparoscopy– A minimally invasive surgical procedure that allows direct visualisation of cysts.

Why Consider Fertility-Sparing Surgeries?

For women planning to conceive, fertility-sparing surgery for ovarian cysts is an effective way to remove cysts while retaining ovarian function.

Key Differences Between Fertility-Sparing and Traditional Surgeries

1. Fertility-Sparing Procedures: Focus on removing cysts while keeping the healthy ovarian tissue intact.
2. Traditional Ovarian Surgery: This may involve removing part or all of the ovary, reducing fertility potential.

Benefits of Fertility-Sparing Surgery

• Preserves ovarian function for natural conception.
• Minimally invasive techniques mean smaller incisions and quicker recovery.
• Lower risk of complications compared to traditional open surgeries.
• Improved hormonal balance post-surgery, leading to better fertility outcomes.

Types of Fertility-Sparing Surgeries

Different surgical techniques are available depending on the type and severity of the ovarian cyst.

1. Open Cystectomy

Open cystectomy involves making a larger incision to remove larger or more complex cysts that cannot be removed laparoscopically.

This procedure is typically recommended for larger, complex cysts or those involving deeper ovarian tissue.

Recovery: Recovery time is longer due to the larger incision, typically requiring 6 days or more in the hospital.

2. Laparoscopic Cystectomy

A minimally invasive procedure that removes ovarian cysts while preserving ovarian tissue.

Recommended for simple cysts, endometriomas, or dermoid cysts.

Recovery: Faster healing, minimal scarring, and quick return to normal activities.

3. Ovarian Drilling (For PCOS Patients)

Helps restore ovulation in women with polycystic ovarian syndrome (PCOS).

Involves making small punctures in the ovary to reduce androgen levels and stimulate ovulation.

4. Endometriosis Excision Surgery

Specifically designed for women with endometriosis-related ovarian cysts (endometriomas).

Removes abnormal tissue while preserving healthy ovarian function to improve fertility.

Pre-Surgery Factors to Consider

Before opting for a fertility-sparing surgery, several factors must be taken into account.

1. Age and Fertility Goals

Women in their late 30s or early 40s may require additional fertility support such as egg freezing.

Younger women may benefit more from minimally invasive options to prolong ovarian function.

2. Type, Size, and Location of the Ovarian Cyst

Larger or complex cysts may require advanced techniques for removal.

Certain cysts (e.g., endometriomas) need precise surgical excision to prevent recurrence.

3. Health History and Previous Surgeries

Prior pelvic surgeries can impact ovarian function and recovery.

Existing medical conditions such as PCOS or endometriosis should be managed before surgery.

4. Choosing the Right Surgeon

Look for a gynaecologist for cystectomy with expertise in fertility-sparing procedures.

Laparoscopic and minimally invasive specialists offer better outcomes with shorter recovery times.

Post-Surgery Recovery and Fertility Care

Recovery after fertility-sparing surgery is generally smooth, but following the right precautions is crucial.

1. Recovery Timeline and Precautions

Laparoscopic Cystectomy Recovery: Most women resume normal activities within 2 weeks.

Avoid heavy lifting or strenuous activity for a minimum of 4–6 weeks.

Monitor for symptoms like excessive pain, bleeding, or fever and consult your doctor if needed.

2. Lifestyle Changes and Nutrition

Follow a balanced diet which contains antioxidants to support ovarian health.

Stay hydrated and active to promote healing and hormonal balance.

Manage stress levels through yoga, meditation, or fertility counselling.

3. Importance of Follow-Ups for Long-Term Fertility Health

Regular ultrasounds and hormone assessments help track ovarian function post-surgery.

Consult a fertility specialist if conception does not occur within 6–12 months post-surgery.

Final Words

Fertility-sparing surgeries are a lifeline for women dealing with ovarian cysts who wish to preserve their fertility. With advancements in laparoscopic techniques, these procedures ensure better outcomes, faster recovery, and enhanced reproductive health. If you're considering surgery for ovarian cysts and wish to protect your fertility, consulting an experienced gynaecologist is the first step toward a well-informed decision.

Visit Krishna Medical Centre for Fertility-Sparing Surgery

Are you concerned about how ovarian cysts may impact your fertility? At Krishna Medical Centre, we specialise in minimally invasive fertility-sparing surgeries for ovarian cysts, PCOS, and endometriosis. Our expert gynaecologist, led by Dr Chandravati, use advanced laparoscopic techniques to ensure safe cyst removal while preserving your reproductive health. Take control of your fertility journey! Schedule a consultation today with our experts for personalised care and treatment