The decision to undergo surgery or proceed with in vitro fertilization (IVF) when you have endometriotic cysts depends on several factors, including the severity of your condition, your age, and whether you are experiencing significant symptoms.
Endometriotic Cysts and Fertility
Endometriotic cysts (also called endometriomas) are cysts filled with endometrial tissue and altered blood that can form on or inside the ovaries. These cysts can affect fertility by:
- Disrupting ovarian function: Large cysts can affect the ovary’s ability to release eggs.
- Adhesions: Endometriosis often causes scar tissue or adhesions, which can affect the fallopian tubes, ovaries, and uterus, making it more difficult for an embryo to implant or for sperm to meet the egg.
- Reduced ovarian reserve: Endometriomas can lower the number of healthy eggs in the ovaries and may negatively impact the quality of eggs retrieved during fertility treatments.
Surgery for Endometriotic Cysts
Surgical removal of endometriotic cysts is a common option, particularly when:
- The cysts are large or causing pain
- The cysts are interfering with ovarian function
- You are struggling to conceive, surgery can help by removing the cysts and any surrounding scar tissue (endometrial adhesions), potentially improving fertility.
While surgery can improve fertility, if pregnancy does not occur as desired, the cysts can reappear sometime later after surgery. There is also concern regarding a drop in ovarian reserve (egg count) due to surgery for removing endometriotic cysts. Therefore, surgery is preferred in younger women who have good egg reserves. Treatment/follow-up must continue after surgery to achieve pregnancy as soon as possible.
IVF (In Vitro Fertilization)
IVF can be an excellent option for women with endometriosis, especially if:
- You have tried other methods unsuccessfully
- Your ovarian reserve is already low
- You have blocked or damaged fallopian tubes
- If there are issues with your partner’s semen
IVF for Women with Endometriosis:
- The presence of endometriomas can make egg retrieval more difficult, especially if cysts are large or are located in a tricky area of the ovary. However, many women with endometriosis are still able to produce enough eggs for IVF.
- Risk of infection is higher when egg retrieval is undertaken in an ovary with endometriotic cysts.
Combination Approach
In many cases, a combination of surgery followed by IVF is the best approach to improving IVF success. You should consult with a fertility specialist who has experience in treating endometriosis. They can evaluate the extent of your cysts and endometriosis, your ovarian reserve, and help you make the best decision for enhancing IVF success.
