The Optimal Time of Ovarian Reserve Recovery After Laparoscopic Unilateral Ovarian Non-Endometriotic Cystectomy

Huaping Li, Bin Yan, Yanli Wang, Zhiming Shu, Ping Li, Yahong Liu, Ying Wang, Xiaohong Ni, Zhou Liu
In: Frontiers in Endocrinology · 2021 · vol. 12 , pp. 671225 · doi:10.3389/fendo.2021.671225 · PMID:34630317 · PMC8498098 · W3203165437
article OA: gold CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study found that ovarian reserve, measured by AMH levels, significantly declined one month after laparoscopic unilateral ovarian cystectomy but recovered optimally by six months post-surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective cohort study evaluated recovery of ovarian reserve after laparoscopic unilateral ovarian cystectomy for unilateral ovarian benign non-endometriotic cysts, enrolling 67 postoperative patients and 69 age-matched healthy women as a referent group. Serum AMH, FSH, and estradiol and ultrasound measures including antral follicle count (AFC) and ovarian arterial resistance index (OARI) were assessed on cycle days 3–5 at baseline and in the first, third, and sixth postoperative months, with a 6-month follow-up. AFC and OARI on the cyst side did not differ from controls across these time points, while AMH declined significantly in the first month in the postoperative group but showed an overall pattern of recovery by 6 months, leading the authors to estimate the optimal recovery time as 6 months. A key limitation explicitly acknowledged by the study design is that it included only women who were 20–30 years old with specific eligibility/exclusion criteria (e.g., no prior pelvic surgeries, no endocrine disease), which may limit generalizability. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background: Laparoscopic ovarian cystectomy is established as the standard surgical approach for the treatment of benign ovarian cysts. However, previous studies have shown that potential fertility can be directly impaired by laparoscopic ovarian cystectomy, diminished ovarian reserve (DOR), and even premature ovarian failure. Therefore, fertility-preserving interventions are required for benign gynecologic diseases. However, there are still little data on the time period required for recovery of ovarian reserve after the laparoscopic unilateral ovarian cystectomy, which is very important for the individualization of treatment protocols. This study aimed at investigating the time needed for the ovarian reserve to recover after laparoscopic unilateral ovarian non-endometriotic cystectomy. Materials and Methods: Sixty-seven patients with unilateral ovarian non-endometriotic cyst from Zhoupu and Punan Hospitals who underwent laparoscopic unilateral ovarian cystectomy were recruited as a postoperative observation group (POG). Also, 69 healthy age-matched women without ovarian cyst who did not undergo surgery were recruited as a referent group (RFG). Ovarian reserve with the serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E2) levels, ovarian arterial resistance index (OARI), and antral follicle counts (AFCs) were measured on the third to fifth days of the same menstrual cycle. A postoperative 6-month follow-up of cases was performed. Results: Compared with RFG, AFC of cyst side in the POG group showed no difference in the first, third, and sixth postoperative month (F = 0.03, F = 0.02, F = 0.55, respectively; p = 0.873, p = 0.878, p = 0.460, respectively). The OARI of cyst side in the POG group revealed no differences in the first, third, and sixth postoperative month (F = 0.73, F = 3.57, F = 1.75, respectively; p = 0.395, p = 0.061, p = 0.701, respectively). In the first month, the postoperative AMH levels significantly declined, reaching 1.88 ng/ml [interquartile range (IQR): 1.61-2.16 ng/ml] in POG and 2.57 ng/ml (IQR: 2.32-2.83 ng/ml) in RFG (F = 13.43, p = 0.000). For the data of AMH levels stratified by age, the same trend was observed between less than 25 and more than 26 years old. At this same time interval, the postoperative rate of decline was significantly lower compared to the preoperative one in POG (32.75%). The same trend was observed between the POG and RFG groups (26.67%). Conclusions: The optimal time for recovery of ovarian reserve after laparoscopic unilateral ovarian cystectomy is estimated to be 6 months.

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