Abstract
Introduction. Endometrioid ovarian cysts (endometriomas) are one of the most common clinical manifestations of endometriosis with a prevalence of 17 to 44% in the population. Laparoscopic cystectomy is currently recognized as the "gold standard" of surgical correction. However, in the last decade, a significant amount of data has been accumulating indicating potential iatrogenic damage to the ovarian reserve during this intervention.
Aim. To carry out a systematic analysis of modern scientific data assessing the effect of laparoscopic cystectomy using bipolar electrocoagulation on the parameters of ovarian reserve in patients of reproductive age with endometrioid and other benign ovarian cysts, as well as to conduct a comparative assessment of the effectiveness of alternative methods of hemostasis.
Materials and methods. A systematic review of the literature published in the period from 2014 to 2024 was performed using PubMed and MEDLINE databases. The search criteria included combinations of keywords: "ovarian reserve", "anti-Mullerian hormone", "AMH", "endometrioma", "laparoscopic cystectomy", "bipolar coagulation", "hemostatic suture", "PlasmaJet". Randomized controlled trials, prospective cohorts, and meta-analyses were selected.
Conclusion. According to relevant studies, laparoscopic cystectomy of endometriomas is associated with a statistically significant decrease in serum concentrations of anti-Muller hormone in the postoperative period, amounting to 30–60% of the baseline level. The use of bipolar coagulation correlates with the most pronounced suppression of ovarian reserve in comparison with alternative methods. The use of hemostatic sutures and plasma coagulation (PlasmaJet) demonstrates significantly better indicators of follicular pool preservation. Laparoscopic cystectomy using bipolar electrocoagulation has a deterministic negative effect on the ovarian reserve. Reducing the risk of iatrogenic damage requires the introduction of organ-preserving surgical techniques into clinical practice, among which priority is given to hemostatic sutures. Preoperative awareness of potential risks and an objective assessment of the ovarian reserve are mandatory components of the management of patients of reproductive age.
Keywords: ovarian reserve, anti-muller hormone, endometrioid cyst, laparoscopic cystectomy, bipolar coagulation, fertility.
For citation:Averyanova A.E., Kulanthaivel S., Alekseeva L.A., Sokur D.A., Tkachenko E.I., Derbunova E.A., Murashova V.S. Potential damage to the ovarian reserve during laparoscopic electrocoagulation of endometrioid cysts and benign ovarian cysts. Clinical review for general practice. 2026; 7 (2): 101–103 (In Russ.). DOI: 10.47407/kr2026.7.2.00775
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