Does ovarian teratoma affect fertility?

Ovarian teratoma is a common gynecological tumor, often appearing on one side. The ovaries are very important to women. With such a disease, everyone is worried that it will affect pregnancy. If you have an ovarian teratoma, it is best to have surgery, and it is ideal to remove it before pregnancy. If not treated in time, it is likely to cause peritonitis, and severe cases may cause shock. If not treated in time, it is likely to pose a threat to life.

Does ovarian teratoma affect fertility? Does it require surgical treatment?

Whether surgery is needed after the discovery of ovarian teratoma depends on the specific circumstances. Generally speaking, the most important means of preoperative differential diagnosis of gynecological tumors are ultrasound examination and tumor marker examination. Teratomas are often manifested as mixed masses, and the disease that most needs to be differentiated from mixed masses is pelvic malignant tumors. If the size of the lump does not exceed 3 cm, the boundaries are relatively clear, the ultrasound shows typical teratoma manifestations such as the "dough sign", and the tumor marker results are within the normal range, and there are plans to become pregnant in the short term, then it can be temporarily not treated under close observation. It generally does not affect conception. Strengthen ultrasound examinations during pregnancy. If there is no obvious increase in size, it can be left for later treatment. If the ultrasound examination results are atypical, or the tumor markers are abnormally elevated, or the mass is larger than 5 cm, it is easy to cause ovarian cyst pedicle torsion, leading to acute abdomen, requiring emergency surgery, or even causing necrosis and requiring removal of one side of the appendages. It is strongly recommended to surgically remove the mass before pregnancy, which can also confirm the diagnosis. Drug treatment of teratoma is ineffective.

What effect does pregnancy have on a teratoma? Will it get bigger or smaller?

Pregnancy generally does not have much effect on the growth of teratoma. However, due to the uneven density of teratoma, the pedicle can be easily twisted due to movement, which is one of the common gynecological acute abdomens. Excessive twisting or prolonged twisting can easily lead to necrosis of the appendages and require surgical removal, which can easily lead to miscarriage, especially in early pregnancy. After pregnancy, the tumor may be squeezed out due to the enlargement of the uterus in the pelvic cavity, or the pelvic cavity may suddenly become empty after delivery, which can easily induce torsion. Therefore, pre-pregnancy treatment is recommended for larger teratomas. In addition, abdominal pressure during pregnancy may cause teratoma rupture, resulting in abdominal pain and other symptoms, making diagnosis and treatment difficult.

How should we deal with ovarian teratoma found during pregnancy?

Some patients do not undergo careful examination before pregnancy and only discover that they have adnexal masses after they become pregnant. At this time, they need to be treated with extra caution. Generally speaking, for patients in early pregnancy, if the lump is relatively large (more than 5 cm) or it is impossible to determine whether it is benign or malignant, surgery is still recommended. You can choose to have the surgery after 3 months of pregnancy. The chance of miscarriage at this time is relatively small. Generally speaking, the cyst can be removed minimally invasively through laparoscopic surgery. It is recommended that the surgery be performed before 18 to 20 weeks of gestation, so that the uterus will not be too large and affect the surgical field of view. Whether the surgery is performed using general anesthesia or combined spinal-epidural anesthesia (a type of local block anesthesia), it is safe for the fetus.