Medical expert of the article
New publications
Endometrioid cyst in pregnancy
Last reviewed: 05.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
The diagnosis of endometrioid cyst during pregnancy means that an ultrasound examination revealed a dense capsule with hemorrhagic contents located outside or inside the ovary.
This cystic formation is a consequence of the proliferation of cells of the internal mucous membrane (endometrium) beyond the uterus.
The detection of this pathology during pregnancy indicates that - despite the disruption of reproductive functions in 30% of women with endometrioid cysts - this patient managed to get pregnant. That is, the size of the cyst was insignificant, and its development did not have time to disrupt the normal functioning of the ovaries.
[ Causes of endometrioid cysts during pregnancy
The list of possible causes of endometrioid cyst formation is quite extensive and partly hypothetical. There is evidence that the causes of endometrioid cysts during pregnancy, which occurs when a woman already has this benign neoplasm, can be directly related to certain hormonal disorders. In particular, this is excessive production of estrogen and prolactin, as well as a deficiency of the corpus luteum hormone progesterone.
It is assumed that the causes of endometrioid cysts during pregnancy may be hidden in genetic mutations, immunodeficiency states, excess fatty tissue in the body, in the endocrine response to stress, as well as in anomalies of the course of menstruation (the so-called retrograde menstruation). In the latter case, there is a reverse flow of menstrual blood and endometrial cells - through the fallopian tubes to the ovaries. Most likely, such anomalies can appear after surgical intervention, abortions that traumatize the uterine mucosa, or long-term contraception using an IUD (intrauterine device).
Symptoms of endometrioid cyst during pregnancy
It should be borne in mind that with small sizes of these pathological formations, the symptoms of an endometrioid cyst during pregnancy, as well as the symptoms of an endometrioid cyst in non-pregnant women, in most cases do not have clinical manifestations.
However, if the cyst becomes large, pregnant women may experience pulling pains in the lower abdomen. And in women outside of pregnancy, in addition to pain, there is a disruption of the monthly cycle, constipation, pain in the lower abdomen (radiating to the lower back) during menstruation, after physical exertion, urination, defecation or intimacy.
Diagnosis of endometrioid cysts during pregnancy
The main methods for diagnosing endometrioid cysts during pregnancy include:
- examination by a doctor on a gynecological chair;
- ultrasound examination (ultrasound) of the pelvic organs;
- biochemical blood test for hormone levels;
- blood test for ovarian tumor markers (CA-125);
- computed tomography (CT), which is prescribed to clarify the location of the cyst and identify the involvement of tissues of other organs in the pathological process.
Who to contact?
Treatment of endometrioid cysts during pregnancy
Treatment of endometrioid cysts during pregnancy differs from the therapy prescribed to non-pregnant women.
According to long-term clinical observations, small endometrioid cystadenomas that do not cause discomfort to a woman do not have a negative impact on the course of pregnancy and fetal development. Moreover, during pregnancy, the placenta produces a large amount of progesterone, the deficiency of which contributes to the appearance of cysts. In addition, from the first days of pregnancy, the female body begins to produce another hormone - human chorionic gonadotropin, which stimulates the thyroid gland and the secretion of its hormones. And this, in turn, helps to accelerate the metabolism in the body and the renewal of all cells.
That is why experienced gynecologists and endocrinologists recommend that women diagnosed with a small endometrioid cyst during pregnancy carry and give birth to a child without waiting for the cyst to grow. At the same time, the doctor supervising the pregnancy should regularly monitor the condition of the cyst using ultrasound.
To correct the hormonal background during the treatment of an endometrioid cyst during pregnancy, "light" hormonal drugs may be prescribed. For example, if there is a lack of endogenous progesterone, the doctor may prescribe the drug Utrozhestan, the active substance of which is the hormone of the corpus luteum of the ovary. Utrozhestan (capsules of 100 and 200 mg) causes changes in the endometrium, which contribute to the retention and development of the embryo. During pregnancy, this drug helps reduce the excitability of the muscle tissue of the uterus and fallopian tubes, and is usually used for habitual spontaneous abortion. The doctor determines the dose individually - in accordance with the results of a blood test for hormone levels: 400-800 mg per day (divided into two doses).
In case of enlargement of the endometrioid cyst during pregnancy, the above-mentioned laparoscopic removal is suggested. This endoscopic operation is usually performed between 14 and 25 weeks, i.e. in the second trimester of pregnancy.
Removal of the cyst is considered mandatory if its size reaches 6 cm or more; with the corresponding indicators of the tumor marker: with severe pain syndrome. And in emergency cases - with suppuration or rupture of the cyst capsule shell, as well as with twisting of the cyst stalk. Although the latter rarely happens with an endometrioid cyst: most often, its capsule is tightly fixed by the surrounding tissues.
More information of the treatment
Prevention of endometrioid cysts during pregnancy
If the main measure aimed at preventing endometrioid cysts in non-pregnant women is a regular visit to the gynecologist (and not only in case of reproductive dysfunction), then the prevention of endometrioid cysts during pregnancy comes down to following all the recommendations of the doctor observing the pregnant woman with such a diagnosis.
Paying extra attention to any changes in your well-being will help the expectant mother successfully cope with her task and give birth to a healthy child.
Prognosis of endometrioid cyst during pregnancy
As already noted, it is possible to become pregnant, carry a child and give birth with a small endometrioid cyst. Therefore, the prognosis of an endometrioid cyst during pregnancy can be called positive. But it is necessary to keep in mind that this disease must be treated. Further growth of the formation can cause adhesions in the pelvic organs and lead to the formation of other types of cysts, for example, follicular.
As a result, an endometrioid cyst during pregnancy - without medical intervention after childbirth - leads not only to ovarian dysfunction and degeneration of eggs, but also to significant disruptions in the functioning of the bladder and colon.
Pregnancy after endometrioid cyst
An endometrioid cyst occurs in women of childbearing age and is often diagnosed in those who seek medical help for infertility. According to gynecologists, if the cyst is small, a woman can become pregnant. But during pregnancy, there is a risk of various complications, since it is impossible to predict the further "behavior" of an endometrioid cyst. Thus, hormonal changes in the body during pregnancy can lead to the disappearance of the cyst. However, under the influence of the same hormones, the cyst can enter a stage of active growth, which can lead to spontaneous abortion. Therefore, the condition of such pregnant women is under particularly careful medical supervision.
When the cyst is of significant size, the functioning of the ovaries and the biosynthesis of hormones are disrupted. In addition, inflammation can begin in the ovaries, and its consequences really make pregnancy impossible. In such a situation, pregnancy should be planned after the removal of the endometrioid cyst.
In gynecology, it is generally accepted that only the removal of an endometrioid cyst will help a woman with this pathology find the joy of motherhood. A modern minimally invasive method for removing an endometrioid cyst is laparoscopy. During laparoscopy, three punctures are made on the abdominal wall and the cyst is removed using special instruments. And the place (the cyst bed) where it was located is treated with a coagulation method (that is, "cauterized"). Given the small size of the ovaries themselves (no more than 30 mm in width), one should not exclude a high probability of injury to healthy tissues and the appearance of adhesions. In addition, after this operation, the woman will also have to undergo a special therapeutic course to normalize hormonal levels. This is due to the fact that in many cases, the removal of an endometrioid cyst, which is a hormone-dependent formation, leads to its reappearance, moreover, repeatedly.
However, doctors are convinced that pregnancy after an endometrioid cyst - in case of its timely removal - is more likely than with conservative treatment of this pathology. By the way, the effectiveness of drug treatment, according to the doctors themselves, is very low in many cases.