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Comparing ovarian reserve after laparoscopic excision of endometriotic cysts and hemostasis achieved either by bipolar coagulation or suturing: a randomized clinical trial

  • General Gynecology
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Abstract

Purpose

This study aimed to compare ovarian reserve between laparoscopic suturing and bipolar coagulation techniques in women with unilateral endometrioma.

Methods

In a prospective randomized clinical trial, 109 patients with unilateral endometrioma underwent laparoscopic cystectomy. Patients were then randomized to undergo hemostasis with either bipolar coagulation (n = 57) or suturing (n = 52) technique. We evaluated the impact of surgery and hemostasis techniques on ovarian reserve using serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) that were measured preoperatively and at 3 months postoperatively.

Results

Baseline characteristics such as age and preoperative AMH and FSH levels were similar between the two study groups. At 3-month follow-up, in both groups, postoperative AMH levels were significantly lower and FSH levels were significantly higher than before surgery. The decline rate of AMH levels was significantly greater in the bipolar coagulation (53.42 ± 15.28) group than in the suturing group (15.94 ± 18.55). Furthermore, patients in the suturing group had higher AMH and lower FSH as compared with the other group (p < 0.001).

Conclusion

After laparoscopic stripping of endometrioma, intracorporeal suturing showed less damage on ovarian reserve as compared with bipolar electrocoagulation. Therefore, hemostatic suturing technique may be considered as a better choice after laparoscopic ovarian cystectomy.

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Acknowledgments

Financial support was provided by the Tehran University of Medical Sciences, Tehran, Iran.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Zahra Asgari, Safoura Rouholamin & Reihaneh Hosseini

  2. Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Beheshti Hospital, Isfahan, Iran

    Safoura Rouholamin

  3. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

    Mahdi Sepidarkish

  4. Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Leila Hafizi

  5. Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadughi University of Medical Sciences, Yazd, Iran

    Atiyeh Javaheri

Authors
  1. Zahra Asgari
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  2. Safoura Rouholamin
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  3. Reihaneh Hosseini
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  4. Mahdi Sepidarkish
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  5. Leila Hafizi
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Corresponding author

Correspondence to Safoura Rouholamin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study was registered in Iranian Registry of clinical Trial (www.IRCT.ir) by the number of IRCT201403088897N2.

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Asgari, Z., Rouholamin, S., Hosseini, R. et al. Comparing ovarian reserve after laparoscopic excision of endometriotic cysts and hemostasis achieved either by bipolar coagulation or suturing: a randomized clinical trial. Arch Gynecol Obstet 293, 1015–1022 (2016). https://doi.org/10.1007/s00404-015-3918-4

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  • DOI: https://doi.org/10.1007/s00404-015-3918-4

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