Effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cyst

Abstract

ObjectiveThis study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts.Material and methodsThis prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision.ResultsLaparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction.ConclusionThe number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.

Changes in anti-Müllerian hormone values for ovarian reserve after minimally invasive benign ovarian cystectomy: comparison of the Da Vinci robotic systems (Xi and SP) and the laparoscopic system

“…It is widely known that when bilateral ovarian cysts are removed, the AMH level decreases significantly compared to when unilateral ovarian cyst is removed 18 – 21 . This is thought to be because more damage may be caused to normal ovarian tissue during the process of removing both ovarian cysts 19 . Also the endometrioma itself may cause damage to the surrounding ovarian tissue, with decreasing serum AMH level 22 .…”

Initial Preoperative Hemoglobin Level Affects the Rate of Decline in Anti-Müllerian Hormone Levels after Laparoscopic Ovarian Cystectomy in Women with Ovarian Endometriosis

“…Histological differences in ovarian cysts and the difference between unilateral versus bilateral cystectomy have been proven to be factors affecting the reduction in ovarian reserve after surgery [ 7 8 9 13 14 15 16 17 ]. However, in addition to the above 2 factors, previous studies on the factors affecting ovarian reserve following ovarian cystectomy remain relatively limited and have yielded conflicting results, thus accentuating the imperative for further comprehensive study [ 6 7 8 9 10 11 12 ]. Therefore, to identify other factors affecting the decrease in ovarian reserve after ovarian surgery besides the above 2 factors of cyst histology and bilaterality, this study was conducted only in patients who underwent unilateral LOC for ovarian endometriosis without other ovarian pathologies, and the results show that only the preoperative initial hemoglobin level exhibited a significant correlation with the rate of decline in the AMH level after LOC in women with endometriosis.…”

“…Laparoscopic ovarian cystectomy (LOC) stands as a minimally invasive surgical procedure necessary for pain relief and the prevention of complications in patients with benign ovarian cysts such as ovarian endometriotic cysts. However, LOC has been identified as a cause of unavoidable reduction in ovarian reserve [ 6 7 8 9 10 11 12 ].…”

“…Hirokawa et al [ 9 ] demonstrated that performing a bilateral cystectomy for endometriomas leads to a significant reduction in serum AMH levels, whereas a unilateral cystectomy maintains AMH levels comparable to those observed before surgery. However, except for the histology of cysts and bilaterality, research exploring other clinical and surgical characteristics affecting ovarian reserve after LOC remains limited, with existing studies often presenting conflicting results [ 6 7 8 9 10 11 12 ], highlighting the necessity for further investigations.…”

Water in the Belly- a Review of Current Knowledge About Ascites in Children

“…Ovarian cysts are estimated to develop in 5-15% of women in reproductive age [83]. They can also be congenital diagnosed prenatally, immediately after birth or later in life [84].…”