Recently, there have been some questions about ovarian teratoma, especially about the effect of teratoma on pregnancy, which has caused a lot of confusion among “mothers-to-be”. Some of the representative questions are listed below for your reference. 1.What is ovarian teratoma? How does ovarian teratoma occur? Ovarian teratoma is one of the more common types of ovarian germ cell tumors, which originates from germ cells in the ovarian tissue. Mature teratomas are the most common and account for the majority of ovarian teratomas. The main feature is that the tumor contains a variety of components inside, such as hair, skin, oil, bone, teeth, brain tissue, etc.; while the structure of the tissues inside malignant teratomas is mostly unclear. After Vu surgery, the patient’s family can see a pile of tissues with hair, teeth, bones and bean milk-like things, which are typical manifestations of teratoma, in fact, it is a skin capsule growing on the ovary, which is wrapped with these components to form a mass. The cause of the development of ovarian teratoma is not known, but it is now believed to be related to abnormal differentiation of germ cells. 2. Do I need surgery after finding an ovarian teratoma? Will pregnancy be affected if surgery is not performed? Can it be treated medically? The need for surgery after the discovery of ovarian teratoma depends on each case. Generally speaking, the most important tools for preoperative differential diagnosis of gynecological tumors are ultrasonography and tumor markers. Teratomas present more often as mixed masses, and the most important disease to identify in mixed masses is pelvic malignancy. If the size of the mass does not exceed 3 cm, the boundary is clear, the ultrasound shows typical teratoma manifestations such as “dough sign”, and the tumor markers are within the normal range, and there is a short-term plan to get pregnant, the mass can be left untreated under close observation, and it usually does not affect conception, and the ultrasound examination can be strengthened during pregnancy. If there is no significant enlargement, it can be left for later treatment. If the ultrasound findings are atypical, or if the tumor markers are abnormally high, or if the mass is more than 5 centimeters or larger, it is likely to cause ovarian cyst torsion and lead to acute abdomen, requiring emergency surgery or even necrosis and removal of one side of the adnexa, so surgery to remove the mass before pregnancy is strongly recommended, as well as to clarify the diagnosis. Teratoma drug treatment is ineffective. 3.What is the effect of pregnancy on teratoma? Will it increase or decrease in size? Pregnancy does not have much effect on the growth of teratoma in general. However, due to the uneven density of teratoma, it is easy to twist due to activity, which is one of the common gynecological emergency abdominal diseases. After pregnancy, due to the enlargement of the uterus in the pelvic cavity, the tumor is crowded, or the pelvic cavity is suddenly empty after delivery, which can easily induce torsion. Therefore, pre-pregnancy treatment is recommended for all large teratomas. In addition, pressure on the abdomen during pregnancy may also lead to rupture of the teratoma, causing abdominal pain and other manifestations, which may cause difficulties in diagnosis and treatment. 4.How should ovarian teratoma be treated when found during pregnancy? Can it be operated? Does anesthesia have any effect on the fetus? Some patients are found to have adnexal masses only after pregnancy due to the lack of careful examination before pregnancy, which requires extra care in the management at this time. In general, for patients in early pregnancy, if the mass is relatively large (more than 5 centimeters) or if the benignity or malignancy cannot be determined, surgery is still recommended and can be done after the third month of pregnancy, when the chances of miscarriage are relatively small and the cyst can generally be removed completely minimally invasively through laparoscopic surgery. It is recommended that the surgery be done before 18 to 20 weeks, when the uterus is not so large as to interfere with the surgical view. The surgery is safe for the fetus regardless of whether general anesthesia or combined lumbar and rigid anesthesia (a type of local block anesthesia) is used. 5. Is it possible to remove the ovarian teratoma together with the delivery? Are there any risks involved in doing so? Of course, if the mass is not detected until late in pregnancy, or if it is considered benign early on and is closely monitored until late in pregnancy, it is possible to have the ovarian cyst removed at the same time as the cesarean delivery. The risk lies in the occurrence of torsion and rupture of the tip during observation resulting in abdominal pain and the need for surgery; a very small number of patients may have delayed treatment because the tumor is malignant. 6.For patients who need to get pregnant in the future, does the surgery have any effect on pregnancy? How long can I get pregnant after surgery? Nowadays, most of the surgeries for ovarian teratoma are performed by laparoscopic minimally invasive surgery, which only removes the tumor and preserves the normal ovarian tissues as much as possible, thus minimizing the effect of surgery on pregnancy and generally speaking, it will not have much effect on conception. Generally speaking, pregnancy can be considered after 2 to 3 months of rest. 7.Do I need to take medicine after surgery? After surgery, there is no need to take medication, only regular review, usually once every 3-6 months for ultrasound. We hope that the above questions will address the concerns of many patients. In addition, it is very important for mothers-to-be to have a good medical check-up before pregnancy, especially gynecological examination. It is very important to pass the gynecological examination as well as TCT (to exclude cervical lesions) and ultrasound (to exclude pelvic masses) before considering conception, as this is crucial for a smooth pregnancy.