| Objective:To study the influence on ovarian reserve after laparoscopic ovarian cystectomy.Methods:70patients treated with laparoscopic ovarian cystectomy in our hospital from February2011to May2012were studied, including21cases of bilateral endometrioma(1st group),29cases of unilateral endometrioma(2nd group),and20cases of unilateral other benign ovarian cyst(3rd group).20patients treated with laparoscopic myomectomy or laparoscopic hydrotubation and fimbrioplasty at the same time were selected as the control group(4th group). Then the serum levels of FSH, LH, E2, AMH, INHB, ovarian volume,AFC,ovarian stromal PI, RI on the third day of menstruation before operation and at1,6, and12months after operation were detected and compared.Results:1) The hormone levels before operation were not significantly different between four groups.2)After1month postoperatively, FSH and LH were significantly increased,E2, AMH, INHB,AFC were significantly reduced in bilateral endometrioma group (1st group).E2, AMH, INHB were also significantly decreased in unilateral endometrioma(2nd group).And in unilateral other benign ovarian cyst(3rd group), only E2was significantly decreased. All of the above,the differences were of statistical significances compared with preoperative levels(P<0.05).The hormone levels of four groups at6,12months postoperatively were not significantly different compared with preoperative level3) At12months postoperatively, in all patients of unilateral ovarian cyst, their ipsilateral ovarian volume, AFC were less than the normal side, on both sides there was a significant difference (P<0.05), while the ovarian stromal blood flow PI and RI had no significant differences between the two sides (P>0.05). In all patients suffered unilateral ovarian cyst, the ovarian stromal blood flow PI and RI in their ipsilateral ovary, showed a downward after operation,and at6,12months postoperatively, which was significant changed compared with preoperative levels (PO.05).4) At1month postoperatively, FSH of the1st group was higher than the2nd group and the4th group(P<0.05). E2, AMH,AFC of the1st group were also lower than the other three groups (P<0.05). LH of the1st group and the2nd group were all higher than the4th group,and INHB of that two groups were also lower than the4th group. All of the above,the differences were of statistical significances.There was no significant difference between the2nd group and the3rd group(P>0.05). At6,12months postoperatively, the hormone levels and AFC also had no significantly difference between four groups(P>0.05).5) Before operation and after1month postoperatively, AFC of the cyst diameter less than or equal to5cm group were higher than those of cyst diameter greater than5cm group,which were significant differences. After1month postoperatively,AMH of the smaller cyst group were higher than those of bigger cyst group,which also was a significant difference.6) After1month postoperatively, AMH and INHB of the group were less than or equal to35years old were significantly higher than that in more than35years old group, there were significant differences (P<0.05).And there was no significant differences between the two groups in other times. Concluisns:1.Using suture for hemostasis and plastic can reduce the damage to ovarian resever during laparoscopic ovarian cystectomy,laparoscopic ovarian cystectomy is safe and effective.2. Laparoscopic ovarian cystectomy have a certain influence on ovarian reserve in the near future, however, long-term effects were not observed in this study. The ovarian volume and AFC of the ipsilateral ovary were lower than the contralateral ovary after laparoscopic ovarian cystectomy,but the ovarian stromal blood flow PI and RI of the ipsilateral ovary were significantly reduced.Ovarian blood supply had been improved, so there were little effect on ovarian reserve.3.After laparoscopic ovarian cystectomy,there was no significant difference between different pathological types of unilateral ovarian cyst in ovarian reserve.4. Only at1month postoperatively, there was significantly difference in ovarian reserve between the bilateral ovarian cysts group with unilateral ovarian cysts group.5. Cyst diameter and age had great influence on ovarian reserve in the near future after operation,long-term effect is not obvious.6. AMH, INHB are more sensitive, more direct than FSH, LH... |
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