Does a teratoma that is too large affect fertility?

Written by Yan Qiao
Obstetrics and Gynecology
Updated on April 01, 2025
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Ovarian teratoma is a type of commonly seen benign ovarian tumor. Even though it is benign, like in the case of teratomas, it can still potentially affect a woman's fertility. The critical factors are the location and the size of the ovarian tumor. If the tumor originates from the center of the ovary, it is likely to cause significant damage to the ovarian tissue. Additionally, if the tumor is large, it can also cause substantial damage to the normal tissue. These factors can impact a woman’s fertility, leading to a decline or even complete loss of reproductive function. Whether fertility is retained depends on the function of the ovary on the other side.

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Written by Zhang Lu
Obstetrics
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Can a teratoma be detected by ultrasound?

Teratomas are a common type of solid tumor in the ovaries, and the vast majority of ovarian teratomas are benign. The most common method to examine teratomas in women is to perform an ultrasound. Generally, an abdominal ultrasound can be done 3-7 days after the menstrual cycle has ended to observe the ultrasonic echo of both ovaries. Normally, both ovaries are uniform in size and echo. If the ultrasound suggests the presence of a substantive mass on the ovary, which has a strong echo, or indicates the presence of fat or bone echoes, then this condition is highly suspected to be a teratoma. For ovarian teratomas, if the size is relatively small and there are no clinical symptoms, temporary observation is possible. However, if it is larger than five centimeters, laparoscopic removal is generally recommended.

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Written by Liu Jian Wei
Obstetrics and Gynecology
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Do ovarian teratomas hurt?

Ovarian teratomas, if without any complications, do not cause abdominal pain. Many people only discover the presence of ovarian teratomas during routine physical examinations. However, if a series of complications occur with ovarian teratomas, they can lead to abdominal pain. For example, the torsion of an ovarian teratoma, can cause the patient to feel sudden acute pain in the lower abdomen on one side. This pain is generally severe and unbearable and may also be accompanied by symptoms such as nausea and vomiting.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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How large must a teratoma be to require surgery?

Ovarian teratomas belong to a type of ovarian germ cell tumor. Ovarian teratomas can be classified into mature teratomas, also known as dermoid cysts, which are a type of benign tumor. There are also immature teratomas, which are malignant tumors commonly found in younger patients, typically between the ages of 11 and 19. If an ovarian teratoma is found to be over three centimeters in diameter, further examinations such as a CA125 test and pelvic CT scan are needed. In the absence of other complications, elective surgical treatment can be planned. However, if the examination reveals high CA125 levels and the pelvic CT confirms the diagnosis, and the cyst is growing rapidly with high blood lipids, timely surgical treatment is necessary, followed by a rapid pathological examination during the surgery.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How is a teratoma surgically removed?

When a woman has an ovarian teratoma, treatment should be determined based on the specific age of the woman, whether the teratoma is benign or malignant, and other factors. For example, if the woman is relatively young and has a benign teratoma and wishes to preserve her fertility, she can undergo ovarian teratoma excision surgery, which can be performed either laparoscopically or through an open surgery. During the operation, the entire teratoma can be completely separated and placed in a specimen bag to prevent contamination of the woman's pelvic cavity and avoid chemical peritonitis or granuloma. If the teratoma is malignant, then it is necessary to remove the adnexa and perform a comprehensive staging surgery. After surgery, based on the results of the pathological examination, it will be decided whether additional treatments such as radiotherapy or chemotherapy are needed.

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Written by Liu Jian Wei
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Do teratomas need to be surgically removed?

If a teratoma is confirmed, it is recommended that the patient undergo surgery immediately to confirm the diagnosis. The surgery for teratoma can be divided into minimally invasive and open surgery. Due to the development of current medical techniques, most teratomas can be operated on using laparoscopy, which is characterized by faster recovery and less trauma. However, in certain special cases, such as when the teratoma is large or the patient is overweight and has a number of other chronic diseases, open surgery can be chosen.