Hi Sara - I really feel for your friend. I've been exactly in her situation.
First on the lap vs open surgery: I found that there are docs who feel more proficient in laproscopic surgeries than others. Some just prefer doing the open procedure. Lap is definitely better and offers easier recovery. She should look for an OB/Gyn that focuses on lap. -
On her pregnancy: I had an u/s done at 10 weeks and the tech found a 6-9mm dermoid cyst on one of my ovaries. A dermoid is a kind of cyst that doesnt resolve on it's own and can be cancerous or turn cancerous if left in for too long. They said it could have been there during my previous pregnancy as well but was small enough not to recognize it on u/s
The PA I saw didnt give me much info except that it looked like a dermoid. Apparently my OB found out I said I would look on the internet when I got home and called me right away to tell me not to freak out, there was no cause at all to terminate the pregnancy over a cyst, even one that can go bad. She explained that we would watch it during the pregnancy and that she would note to have another u/s done at 6 months. If the worst case happened and I did need surgery during pregnancy, it would not require terminating the baby. She said if I had to have a c-section delivery, she would remove it at the same time otherwise we would schedule surgery once my body normalized after pregnacy in 4-6 months. I delivered in April, had surgery in October and my pregnancy and delivery was actually very easy.
Whether or not your friend loses an ovary depends on the size and position of the cyst. Sometimes they get all wrapped up on the ovary.
I hope that helps give you some information. I think if she is pregnant with a baby that she and her husband have been trying so hard to have, she should do everything she can to protect her baby. The cyst is going to be there no matter what and is going to require treatment but she should find a doc who is willing to help her manage it until the baby is born and then offer surgery.