Influence of various hemostatic methods on ovarian reserve function in women with ovarian endometriotic cyst treated by laparoscopic cystectomy

Abstract

To investigate the influence on ovarian reserve function in treatment of ovarian endometriotic cyst by laparoscopic cystectomy with various hemostasis management. From September 2007 to August 2008, 61 patients with bilateral ovarian endometriotic cyst in Peking University First Hospital and Anzhen Hospital Affiliated to Capital University of Medicine were treated by laparoscopic cystectomy. Those patients were divided into two groups randomly, which were 28 patients in suture group and 33 patients in electro coagulation during the operation. Blood samples were obtained from the patients before the operation, on the day 2 or 3 of the second menstrual cycle after operation and the first menstrual cycle after 6 months operation. The serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)) were tested. At the same time, total antral follicles (F(0)) and mean ovarian stromal peak systolic blood flow velocity (PSV) were detected by transvaginal ultrasonography to evaluate ovarian reserve function. There was no significant difference in patients' clinical characteristics and ovarian reserve function between two groups (P > 0.05). In the suture group, the serum level of FSH were (10.2 +/- 2.0) U/L before operation, (11.0 +/- 2.2) U/L on day 2 or 3 of the second menstrual cycle and (11.5 +/- 2.5) U/L on day 2 or 3 of the first menstrual cycle after 6 months'operation respectively. In comparison of data before operation, it exhibited significant difference (P < 0.05); F(0) were 8.9 +/- 2.6 before operation, 7.8 +/- 2.1 on day 2 or 3 of the second menstrual cycle and 7.6 +/- 2.4 on day 2 or 3 of the first menstrual cycle after 6 months' operation. When compared with data before operation, it showed significant difference (P < 0.05); PSV were (0.104 +/- 0.017) m/s before operation, (0.084 +/- 0.016) m/s on day 2 or 3 of the second menstrual cycle, (0.086 +/- 0.022) m/s on day 2 or 3 of the first menstrual cycle after 6 months' operation, it also showed significant difference between preoperation and postoperation (P < 0.01). In the electro coagulation group, the serum level of E(2) were (166 +/- 19), (196 +/- 57), (205 +/- 65) pmol/L, serum level of FSH were (10.0 +/- 1.5), (12.2 +/- 2.6), (13.4 +/- 4.5) U/L, F(0) were 8.9 +/- 2.0, 6.5 +/- 2.0, 6.2 +/- 2.5 (P < 0.01); PSV were (0.101 +/- 0.016), (0.072 +/- 0.021), (0.067 +/- 0.024) m/s before operation and on day 2 or 3 of the second menstrual cycle after operation and the first menstrual cycle after 6 months operation. They all showed significant difference between preoperation and postoperation. In the second menstrual cycle post operation (on day 2 or 3), the data of F(0) and PSV were statistically different between the two groups (P < 0.05); in the first menstrual cycle 6 months after the operation (on day 2 or 3), The serum level of E(2), F(0) and PSV were statistically different between the two groups (P < 0.05). It suggested that ovarian reserve function would be decreased in treatment of bilateral ovarian endometriotic cyst by laparoscopic cystectomy, it was more serious when electro coagulation hemostasis were given.