Comparison of impact on ovarian reserve between laparoscopic and laparotomy ovarian cystectomy

Abstract

Comparison of impact on ovarian reserve between laparoscopic and laparotomy ovarian cystectomy N. Eamudomkarn, L. Salang, K. Seejorn, P. Kleebkaow Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen (Thailand) Summary Objective: To compare the effects of laparoscopy and laparotomy in unilateral ovarian cystectomy on ovarian reserve by measuring serum anti-Müllerian hormone (AMH) levels. Design: Prospective cohort single-blind study. Setting: Tertiary care university hospital. Materials and Methods: Fifty-two patients with unilateral benign ovarian cysts were prospectively recruited from March to December 2016. Twenty-six patients underwent laparoscopic ovarian cystectomy and the other 26 underwent laparotomic ovarian cystectomy. Serum samples were obtained from all the study population preoperatively and two months postoperatively for AMH measurement. The number of follicles attached to the removed cyst wall were counted and recorded by a gynecological pathologist. Results: A statistically significant decrease in ovarian reserve at two months postoperatively was found in the laparotomy group when compared to the laparoscopy group. There was no difference in the number of follicles retained in the removed ovarian cyst walls between groups. No major operative complications occurred in either group. Conclusion: Patients undergoing ovarian cystectomy using a laparoscopic approach had better postoperative ovarian preservation when compared to conventional laparotomy. Key words: Ovarian cysts; Ovarian cystectomy; Ovarian reserve.