I'm sorry you're going through this. I know our minds tend to think the worst which doesn't do us any favors. But thankfully, the large majority of ovarian cysts, even complex ones, are benign. And imaging is not perfect so they cannot always tell the type of cyst. For example, hemorrhagic (blood filled) cysts that typically resolve on their own can appear solid (and concerning) on imaging. Multiple adjacent cysts can give the appearance of one big cyst with septations (making it appear complex). Endometriomas can't always be differentiated from other types of cysts, etc. But again, most ovarian cysts are benign and most go away on their own.
The cyst that appears to be complex is still very small so it seems monitoring would be the recommendation if you don't have a family history of ovarian cancer.
I think the explanation for your ovaries being enlarged is because of the cysts. The only thing I can say about a nodule is that a blood clot in a hemorrhagic cyst can appear as a nodule. I'm not sure of the implications of nodules and their various types, e.g. mural.
You are right to want to keep your ovaries even if it weren't for fertility. All our female organs are essential our whole lives for good health. The ovaries of women with all their parts have been shown to produce hormones their whole lives protecting them from many chronic health problems. Overy.org talks about the negative effects of ovary removal. Removal of even one ovary has been shown to do more harm than good. Hysterectomy (uterus removal) is also damaging in a number of ways - hormonal / endocrine, sexual, anatomical (pelvic organ displacement), and skeletal (back, hips, figure changes).
If you do end up needing surgery, you will want to find a surgeon who has good cystectomy (cyst removal) skills to preserve your ovary or enough of it for normal function. According to this website by a doctor who does a lot of cystectomies, most cysts can be removed without removing the ovary - http://ovaryresearch.com/ovarian_cysts.htm.
Let us know what you find out from the oncologist. I wish you the best!
Did you see the oncologist? What did you find out?
I've been referred to a reproductive endocrinologist. The complex cyst with mural nodule on the right ovary has resolved on its own. The largest cyst on the left has grown a bit (5cm to 5.6cm) and is now identified as complex. The radiologist noted that it seemed likely to be either a hemorrhagic cyst or endometrioma.
The new doctor I've been seeing is suggesting surgical removal, though we did discuss potential damage to the ovary and how to avoid/minimize, and that I don't want to come out of surgery missing an ovary. At my last appointment, they took lots of blood and, among other things, are checking my AMH. If it's low, they may just put off surgery unless the cyst's growth rate increases and I further risk torsion.
At least for now, it seems likely benign.