COMPARATIVE STUDY BETWEEN LAPAROSCOPIC AND OPEN OVARIAN CYSTECTOMY ON OVARIAN RESERVE

Abstract

Objective: To investigate the impact of electrocoagulation on ovarian reserve after laparoscopic excision of ovarian cysts and the possible mechanisms.
Design: A prospective study.
Setting: Obstetrics and Gynecology Department of a university hospital.
Patient(s): 100 patients with benign ovarian cysts undergoing ovarian cystectomy.
Intervention(s): Laparoscopic ovarian cystectomy using bipolar electrocoagulation and laparotomic ovarian cystectomy using sutures after the excision of ovarian cysts.
Main Outcome Measure(s): Follicle-stimulating hormone (FSH & AMH) assays and transvaginal ultrasound evaluating basal antral follicle number, mean ovarian diameter, and ovarian stromal blood flow velocity at cycles 1, 3 and 6 after surgery.
Result(s): When comparing the bipolar group with the suture group, a statistically significant increase of the mean FSH value was found in bilateral-cyst patients at 1-, 3- and 6-month follow- up evaluations and in unilateral-cyst patients at the 1-month follow-up evaluation. When comparing the bipolar group with the suture group, a statistically significant decrease of the mean AMH value was found in bilateral-cyst patients at 1-, 3- and 6-month follow- up evaluations and in unilateral-cyst patients at the 1-month follow-up evaluation. Statistically significant decreases of basal antral follicle number and mean ovarian diameter were found during the 3-, 6-month follow-up evaluations as well as statistically significant decreases of peak systolic velocity at all of the follow-up evaluations.
Conclusion(s): Electrocoagulation after laparoscopic excision of ovarian cysts is associated with a statistically significant reduction in ovarian reserve, which is partly a consequence of the damage to the ovarian vascular system.
Key Words: Ovarian cysts, laparoscopic ovarian cystectomy, electrocoagulation, ovarian reserve