Changes in ovarian reserve function after laparoscopic ovarian cystectomy: a retrospective cohort study.

ObjectiveTo explore the effect of laparoscopic ovarian cystectomy on ovarian reserve function and its related risk factors.MethodsThe clinical data of 150 patients with unilateral ovarian cysts admitted to our hospital were retrospectively analyzed. Paired t-tests were used to compare changes in indicators before and after surgery. One-way analysis of variance was performed to compare differences among different groups. Multivariable logistic regression analysis was used to identify independent risk factors for significant postoperative AMH decrease.ResultsAt 1, 3, 6, and 12 months after surgery, the AMH levels were significantly lower than those before surgery, while the FSH levels were higher than those before surgery (P < 0.05). At 12 months after surgery, the decrease in AMH levels and the increase in FSH levels in the cyst diameter ≥7 cm group were significantly greater than those in the cyst diameter <5 cm and 5 - 7 cm groups (P < 0.001). The decrease in AMH and the increase in FSH in the electrocoagulation hemostasis group were significantly greater than those in the suture hemostasis group (P < 0.05). Among 86 patients with fertility intentions, the overall pregnancy rate was 59.3% (51/86), and the live birth rate was 48.8% (42/86). Multivariable logistic regression analysis showed that cyst diameter ≥7 cm (OR = 3.610, 95%CI: 1.835 - 7.103), endometriotic cysts (OR = 2.063, 95%CI: 1.106-3.848), electrocoagulation hemostasis (OR = 2.633, 95%CI: 1.232 - 5.627), and moderate-to-severe ovarian tissue loss (OR = 4.697, 95%CI: 2.312 - 9.545) were independent risk factors for significant postoperative AMH decrease (≥30%) (P < 0.05).ConclusionsLaparoscopic ovarian cystectomy causes some damage to ovarian reserve function. After surgery, AMH levels decrease and FSH levels increase, but these levels gradually recover over time. Larger cyst diameter, endometriotic cysts, electrocoagulation hemostasis, and moderate-to-severe ovarian tissue loss are independent risk factors for postoperative ovarian reserve function damage.