Does ovarian cystectomy pose a risk to ovarian reserve and fertility?

Abstract

Key content The impact of benign ovarian cysts on a woman’s fertility is dependent on the nature, size, number, bilaterality and risk of recurrence of the cyst(s). Children and adolescents presenting with pathological ovarian cysts require a multidisciplinary team approach and, where possible, fertility sparing treatment should be offered. Laparoscopic detorsion has the potential to preserve ovarian reserve and should remain the optimal treatment for ovarian torsion in girls and premenopausal women. Surgery for bilateral endometriomas has been shown to increase the risk of developing premature ovarian insufficiency. It is important to consider performing ovarian reserve assessments before any ovarian surgery in women who have not completed their family. Learning objectives To understand what factors need to be considered before making a decision to perform an ovarian cystectomy. To be aware of different surgical techniques and their impact on fertility outcomes. To take anatomical considerations into account to minimise damage to healthy ovarian tissue. Ethical issues The UK’s National Health Service does not routinely fund oocyte freezing for benign conditions.