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Ovarian cysts are one of the commonest problems encountered in the gynecological field. Majority of these cysts are functional i.e., disappear spontaneously, while few need cystectomy. Ovarian cystectomy is done by laparotomy and laparoscopic technique. The method to achieve haemostasis in the ovarian bed after cyst removal varies with the type of technique. Electrocoagulation is used to achieve haemostasis in laparoscopic cystectomy while the bleeding vessels are sutured for haemostasis in cystectomy by laparotomy. Both the modalities of management varies in terms of compromise of ovarian reserve. The study was carried out to evaluate the surgical impact of benign ovarian masses on ovarian reserve as measured by serum levels of antimullerian harmone. In this prospective study on 30 women of reproductive age group with benign ovarian masses, 15 women were enrolled for laparoscopic ovarian cystectomy and another 15 women were enrolled for cystectomy by laparotomy and ovarian reserve was measured by levels of serum AMH preoperatively, postoperative one week and postoperative 3 months using standard ELISA assay kit. The preoperative, postoperative one week and postoperative 3 months levels of mean AMH were 4.74 ± 1.86 ng/ml, 2.92 ± 1.45 ng/ml and 2.64 ± 0.96 ng/ml respectively, in women undergoing laparoscopic cystectomy and 3.98 ± 1.35 ng/ml, 2.48 ± 0.64 ng/ml and 2.11 ± 0.63 ng/ml respectively in women undergoing ovarian cystectomy by laparotomy. So there was decline of mean AMH levels in postoperative one week and postoperative 3 months samples in both of the groups of enrolled women. However, this decline varied with the type of cyst removed and is insignificantly greater in laparoscopy group, wherein electrocoagulation may cause extensive and sustained damage to ovarian tissue.

Evaluation of ovarian reserve in women undergoing ovarian cystectomy by laparoscopy and laparotomy