Effect of Laparoscopic Suturing versus Bipolar Coagulation on Ovarian Reserve in Patients Undergoing Endometriotic Ovarian Cystectomy. A Randomized Controlled Trial

Abstract

varian cysts are a common gynecological problem, occurring in approximately 6.6% of reproductive age women. The decision to operate is more important in infertile patients and patients desiring further fertility. Laparoscopy is the preferred surgical technique for ovarian cystectomy because this minimally invasive technique features reduced intraabdominal adhesion, operative pain, and hospitalization times (Brun et al., 2014). Endometriosis as an enigmatic disease is most commonly found on the ovaries and presents with pelvic pain and infertility (De Ziegler et al., 2010). Laparoscopic cystectomy for endometrioma is a favorite modality for many surgeons with the reported benefits such as lower recurrence rate and better response to ovarian stimulation (Littman et al., 2005; Moscarini et al., 2014). Based on literatures, factors affecting ovarian reserve were cyst size, recurrences, bilateral case, techniques of surgery, skill of surgeon, and hemostasis method (Reich and Abrao, 2006; Hart et al., 2008; Raffi et al., 2012; Ferrero et al., 2012). The most common side effect of cystectomy is damage to healthy ovarian tissue; therefore, application of new techniques with lower adverse effects on ovarian reserve is a current concern. AMH level has been considered as a reliable and useful marker of ovarian reserve (Toner and Seifer, 2013).