Effects of ovarian cyst types on ovarian reserve after three-dimensional laparoscopic cystectomy.

Abstract

Objective: This study aims to compare the effects of three-dimensional (3D) laparoscopic ovarian cystectomy on ovarian reserve according to different types of ovarian cysts.

Materials and methods: Participants who underwent surgical treatment for ovarian cysts between 2018 and 2020 were included in this study. Anti-müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels were measured before surgery and six months postoperatively. All procedures were performed under general anesthesia using 3D laparoscopy. Participants were classified into three groups based on histopathological findings: group 1, endometriomas; group 2, mature cystic teratomas (dermoid cysts); and group 3, serous or mucinous cystadenomas.

Results: A total of 51 women were included in the study. No significant differences were observed between the groups in terms of perioperative variables such as operation time, intraoperative blood loss, postoperative hemoglobin decrease, and maximum cyst diameter. There were also no significant differences among the groups in preoperative AMH (p=0.97) and FSH (p=0.22) levels. Postoperative AMH levels were significantly lower than preoperative values in both the endometrioma group (p<0.001) and the dermoid cyst group (p=0.004). The reduction in AMH levels was more pronounced in the endometrioma group compared to the other groups. Postoperative FSH levels tended to increase in all groups compared to preoperative levels; however, this increase was not statistically significant (p=0.092).

Conclusion: 3D laparoscopic cystectomy for the removal of endometriomas and dermoid cysts significantly reduces ovarian reserve. In contrast, laparoscopic cystectomy for serous or mucinous cysts appears to have no significant impact on ovarian reserve.