Impact of Laparoscopic Ovarian Cystectomy on Ovarian Reserve

Abstract

Objective: The aim of this research was to determine the impact of laparoscopic ovarian cystectomy on ovarian reserve. Materials and Methods: This was a prospective observational study carried out on 15 women, 15–40 years of age, who underwent laparoscopic ovarian cystectomy for symptomatic benign ovarian cysts of size >7 cm in the Department of Obstetrics and Gynaecology at Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, in Rohtak, Haryana, India, a tertiary care center of north India. Bipolar electrocoagulation was used for hemostasis on the ovarian bed during surgery. Serum anti-Müllerian hormone (AMH) was measured 1 day prior to surgery (D0), on postoperative day 7 (D7), and on day 90 (D90), using an enzyme-linked immunosorbent assay. The data were analyzed using SPSS 16. Results: The mean age in the study was 27 ± 6.92 years and 13 (86.66%) women were under age 35. Three (20%) women had presented with infertility, and the remaining (80%) with dull abdominal pain. A declining trend of mean AMH levels with increasing age and cyst size was noted in the study. Nine (60%) women had AMH values between 2.1 and 5 ng/mL preoperatively, while 6 (40%) had values between 5.1 and 9 ng/mL. However, on D7, 9 women (60%) had values between 1 and 3 ng/mL on D7, suggesting a decline in AMH values in some women who had higher levels earlier. All women in the study had preoperative AMH values >2 ng/mL, indicating optimal ovarian reserve, while 5 (33.33%) women on D7 and 2 (13.33%) women on D90 had AMH levels <2 ng/mL, suggesting some recovery in 3 cases. A significant fall in mean AMH levels was seen between D0 and D7 (38.78%; p < 0.001) and between D0 and D90 (46.73%, p < 0.001) in the study. Conclusions: Laparoscopic ovarian cystectomy using bipolar coagulation causes a significant continuous decline in ovarian reserve as measured by serum AMH. (J GYNECOL SURG 33:129)