Until we decide that we’re ready to start a family we are usually so preoccupied with avoiding conception that we may not think about how our gynaelogical health may affect our fertility.
Here are some of the most common causes of sexual health-related worry for women trying to conceive or newly pregnant.
Ovarian cysts
Ovarian cysts are very common, usually benign and nothing to worry about. In many cases women aren't even aware that they have a cyst and they may disappear and reappear with no impact on your fertility at all. If you have a cyst that is large enough to cause pain, then your doctor may have referred you for an ultrasound and diagnosis. Even in these cases cysts are usually nothing to worry about and if they don't disappear by themselves within a few cycles then a course of contraceptive pills will usually be effective in shrinking the cyst. In this case your fertility will only be affected while you are taking the contraceptive pill.
Expert Tip
Previous surgery or infection can cause damage to the fallopian tubes – this causes over 16% of all female infertility problems.
In some cases an ovarian cyst may be more problematic and complex cysts that don't disappear on their own or with several months of contraceptive pills may need to be removed surgically and sometimes the whole ovary will also need to be removed. In a small number of cases ovarian cysts may be cancerous, in which case urgent treatment is vital and at least one ovary will probably need to be removed. If you have already had an ovary removed for one of these reasons then see below for how this may affect fertility.
Polycystic Ovarian Syndrome (PCOS)
Women with PCOS have multiple small cysts on their ovaries, which cause irregular menstrual cycles and can disrupt ovulation, or cause anovulation. The condition is consequently a common cause of infertility, but it is also quite common and can usually be treated successfully and most women with the condition will eventually be able to become pregnant.
If you have already been diagnosed with PCOS and now want to start a family then speak to your doctor right away about treatment, rather than waiting the usual 12 months, as the chances are that you may have difficulties conceiving. Medications, usually oral, can be given to stimulate ovulation and most women are able to get pregnant in this way within about six to nine months. For those women who don't become pregnant with the help of medication, IVF will probably be successful.
Removal of an ovary
If you have had one ovary removed (whether due to ovarian cancer or an ovarian cyst) then your fertility will depend fully on the health of the other ovary. If the other ovary is healthy then it will take over the role of both ovaries, releasing an egg every month instead of every two months, and your fertility levels will be unaffected.
For women with ovarian cancer, early diagnosis and treatment raises the possibility of the surgery leaving one healthy ovary intact, although in many cases surgeons may not know until they operate how much tissue they will have to remove. Where fertility-sparing surgery is possible there is still a chance of cancer recurring in the second ovary at a later stage.
There is a chance that your fertility may be lowered following surgery to remove an ovary if the surgery results in uterine adhesions. You should also be aware that the removal of one ovary would bring your menopause forward by about a year.
