Ovarian Cyst Diagnosis & Treatment with Aspiration

An ovarian cyst is a common finding in women of reproductive age, often causing concern—especially when associated with fertility issues. Although many cysts are benign and resolve on their own, in certain cases, they negatively affect ovulation or the IVF process. Ovarian cyst aspiration is a targeted, minimally invasive solution that can enhance IVF success rates by preventing the cancellation or delay of a treatment cycle. At Fertulity, our specialized team and modern equipment allow us to evaluate each case individually, aiming for optimal medical care and full support in your reproductive journey.

What Is an Ovarian Cyst?

Laparoscopy is a modern, minimally invasive endoscopic surgical method that allows direct examination of the abdominal cavity and, in particular, detailed evaluation of the female internal reproductive organs — the uterus, fallopian tubes, and ovaries. Through a small incision near the navel, about 1 cm in diameter, a thin telescope (laparoscope) is inserted, providing high-definition imaging of the abdominal interior. At the same time, with the help of another 2–3 auxiliary incisions (0.5–1 cm), specialized surgical instruments are introduced to perform the necessary procedures. During the process, the abdomen is inflated with carbon dioxide, which creates the required space for clear visualization and safe manipulation of the organs. This method gives the physician not only visual access but also the ability to perform immediate therapeutic interventions, thus reducing the need for more invasive techniques such as laparotomy.

Common Types of Cysts (Functional, Dermoid, Endometriotic)

There are several types of cysts, each with different causes, prognosis, and treatment needs:

Functional cysts

These are the most common and form during the normal menstrual cycle. They include follicular cysts and corpus luteum cysts. They usually don’t cause symptoms and resolve on their own within a few weeks.

Dermoid cysts (mature teratomas)

These are congenital cysts containing various tissue types like skin, hair, or fat. They are typically benign but may grow and cause pain or ovarian torsion.

Endometriotic cysts (endometriomas)

These form when endometrial-like tissue develops in the ovaries, creating a cyst filled with thick, dark fluid (often called "chocolate cyst"). They are closely linked with endometriosis and frequently associated with infertility.

When Should We Worry About a Cyst?

Although most cysts are benign and temporary, some cases require closer attention.

Further investigation is recommended when:

The cyst persists or grows after two or more cycles.

The cyst's diameter is larger than 4–5 cm.

Symptoms such as abdominal or pelvic pain, pressure, bloating, or irregular periods are present.

There is suspicion of endometriosis or history of polycystic ovaries.

The cyst is found in a woman trying to conceive, as it may affect ovarian function or response to IVF medications.

Early diagnosis and proper differential diagnosis are crucial—not only for protecting women's health but also for maximizing IVF success. At Fertulity, every cyst is individually evaluated using advanced diagnostic tools and extensive reproductive medicine expertise.

How Are Cysts Related to Infertility?

The presence of an ovarian cyst may directly or indirectly impact a woman's fertility, depending on its type, size, and behavior. In some cases, cysts interfere with follicle maturation or hormonal balance, while in others, they indicate an underlying condition such as endometriosis, which independently reduces conception rates.

How They Affect Ovulation and IVF

Functional cysts, such as follicular or corpus luteum cysts, may prevent the start of a normal ovulation cycle. If a cyst is present, the ovary might not respond well to stimulation drugs, as the existing fluid-filled sac can disrupt hormonal function. Additionally, during IVF cycles, the presence of a cyst may reduce stimulation efficacy, limit egg production, or even lead to cycle cancellation.

Endometriotic cysts, on the other hand, are more complex to treat. They are associated with inflammation, ovarian tissue dysfunction, and reduced ovarian reserve. In these cases, infertility stems from both mechanical and hormonal factors.

Treatment – Ovarian Cyst Aspiration

Ovarian cyst aspiration is a minimally invasive method applied in select cases where the cyst may affect an assisted reproduction cycle or cause symptoms. The decision to proceed depends on specific medical indications and is always personalized to ensure safe and effective treatment.

When Is Aspiration Recommended?

Aspiration is mainly advised when:

The cyst persists over multiple cycles and does not resolve naturally.

It exceeds 3–4 cm and compresses ovarian tissue.

The ovary responds poorly to stimulation drugs, resulting in low follicle production.

The IVF cycle is at risk of cancellation or delay.

The patient experiences discomfort or pain.

There is a history of endometriosis or recurring cysts.

The decision is made following detailed ultrasound evaluation and consultation with a fertility specialist, aiming for the best medical strategy.

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Step-by-Step Procedure

Ovarian cyst aspiration is a simple, quick procedure typically completed in just a few minutes in a specialized gynecological setting:

Preparation

The patient is thoroughly informed, and an ultrasound confirms the cyst's location and characteristics.

Local anesthesia or mild sedation

Depending on the case, light sedation is administered for comfort and immobility.

Ultrasound-guided aspiration

A thin needle is inserted transvaginally under ultrasound guidance. The cyst fluid is fully drained.

Monitoring

After the procedure, the patient rests for about 30 minutes and can resume daily activities the same day.

Content analysis (if needed)

If the cyst’s origin is unclear, the fluid may be sent for cytological or microbiological analysis

The procedure is painless, requires no incisions, and provides immediate relief to the ovarian tissue—without hospitalization.

Alternative Approaches (monitoring, cystectomy)

Depending on the case, alternative approaches may be suggested:

Monitoring: For small, asymptomatic cysts—especially functional types—regular ultrasound follow-up is often the best approach.

Surgical cystectomy: For large or complex cysts, particularly if endometrioma or dermoid is suspected, laparoscopic removal may be more appropriate, especially if symptoms or recurrence are present.

The choice of method depends on clinical criteria, the patient’s reproductive profile, and the stage of the treatment plan.

Benefits of Aspiration

Cyst aspiration is a fast, safe, and effective approach offering multiple advantages for women undergoing assisted reproduction:

Improved IVF cycle outcomes

Removing the cyst allows even follicle growth and balanced drug response, increasing the chances of retrieving more high-quality eggs.

Less medication burden

Avoids the need for higher medication doses, reducing both costs and potential side effects.

Quick recovery and treatment continuity

The procedure requires no hospitalization and allows the patient to continue treatment seamlessly without delays or cancellations.

Aspiration is thus a valuable tool for supporting and optimizing infertility treatment—when applied with the right criteria under an experienced medical team.

Frequently Asked Questions About Ovarian Cyst & Aspiration Treatment

Is aspiration painful?

Ovarian cyst aspiration is usually painless or causes minimal discomfort, as it’s performed under local anesthesia or mild sedation. Ultrasound guidance ensures maximum precision and comfort throughout. Most women report no significant pain, and recovery is almost immediate.

How long does recovery take?

Recovery is immediate, and patients can resume daily activities the same day. No hospitalization is needed, and in most cases, no post-procedure medication is required. Mild abdominal discomfort or pressure is rare and subsides within a few hours.

Can the cyst return?

Cyst recurrence depends on the type. Functional cysts may reappear in future cycles, especially in women with hormonal imbalances. Endometriotic cysts carry a higher recurrence risk. At Fertulity, we investigate root causes and design personalized prevention and monitoring plans.

Will it affect my IVF treatment?

Not only does it not hinder IVF—it often improves outcomes. Removing a cyst via aspiration reduces the risk of cycle interruption, enhances drug response, and facilitates egg collection. It’s a tool commonly used to optimize stimulation conditions.

Is it safe during pregnancy?

Aspiration is not performed during pregnancy unless there are serious medical indications, such as torsion or cyst bleeding. In all other cases, evaluation and treatment are done before IVF or pregnancy to ensure safety and prevent complications.

Our Doctors

In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Maria Oikonomou Obstetrician – Gynecologist

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Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I