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

Background Women enter menarche with approximately 500000 primordial follicles, which slowly drop in number throughout their reproductive lifetimes. Aim of the Work to determine which hemostatic procedure (hemostatic suture or electrocautery) may be less harmful after laparoscopic cystectomy, based on the status of the ovarian reserve. Patients and Methods The study was conducted at Ain Shams University Maternity Hospital, Obstetric and Gynecology Department, Faculty of medicine. The study population comprised females in childbearing period undergone laparoscopic endometriotic ovarian cystectomy at Ain Shams University Maternity Hospital, Obstetric and Gynecology Department, Faculty of medicine. Results There was no statistically significant difference found between the two studied groups regarding AMH, AFC and FSH preoperative with p-value = 0.188, 0.533 and 0.812 respectively. While there was statistically significant increase in AMH and AFC in suturing group than cautery group postoperative with p-value < 0.001 and 0.005 respectively and also statistically significant decrease in FSH in suturing group than cautery group postoperative with p-value 0.004. Results of this study showed that there was statistically significant increase in the percentage of change of FSH in cautery group (61.59 ± 39.29) than suturing group (23.46 ± 17.87) with p-value < 0.001 while there was statistically significant lower rate of change in AFC and AMH in suturing group than cautery group with p-value = 0.001 and < 0.001 respectively. Conclusion laparoscopic cystectomy reduces the ovarian reserve, which is more affected by hemostatic electrocoagulation than hemostatic sutures.