Strakhovetskyi V. S., Katamadze S. N.

COMPARATIVE ANALYSIS OF CHANGES IN OVARIAN RESERVE AFTER LAPAROSCOPIC CYSTECTOMY OF BILATERAL ENDOMETRIOMAS

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Strakhovetskyi V. S., Katamadze S. N.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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Endometrioid ovarian disease occupies a leading place in the structure of causes of female infertility. Although cystectomy of endometriomas more frequently damages the ovarian reserve, it still remains the primary treatment option for endometrioma. Therefore, the aim of the study was to compare the effects of different intraoperative he mostasis methods (precision bipolar coagulation and suturing of the cyst bed) on the ovarian reserve in patients with bilateral endometriomas. The study included 26 patients with bilateral endometrioid ovarian cysts who were divided into two groups depending on the type of laparoscopic intervention: in group I (n=10), a standard cystectomy tech nique using a bipolar coagulator was applied; in group II (n=16), an organ-preserving technique of “cold dissection” with hemostasis achieved by suturing the ovarian tissue was used. The obtained results were statistically processed. The main marker of ovarian reserve was the serum level of anti-Müllerian hormone (AMH) measured before surgery and 4 months after the operation. The baseline AMH level in patients of both groups was below the normal range, confirming the negative effect of bilateral endometriomas on the follicular apparatus: in group I – 2.4±0.3 ng/mL, and in group II – 2.6±0.3 ng/mL. Evaluation of ovarian reserve dynamics 4 months after surgery revealed significant differences between the groups: the relative decrease from the baseline value in group I was 46.2% (1.3±0.2 ng/mL), whereas in group II it was 18.4% (2.1±0.3 ng/mL). The obtained data indicate that bilateral endometrioma cystec tomy is a traumatic intervention that inevitably leads to a decrease in ovarian reserve; however, the degree of this decline critically depends on the chosen hemostasis method. For nulliparous patients, especially in cases of bilateral involvement, the method of choice should be laparoscopic cystectomy with avoidance of electrical energy and the use of microsurgical suturing techniques.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 1, 180, 364-372 pages, index UDC 618.11-006-089.819:612.622:616-037

DOI:

10.29254/2077-4214-2026-1-180-364-372