Impact of hemostasis methods, electrocoagulation versus suture, in laparoscopic endometriotic cystectomy on the ovarian reserve: A randomized controlled trial

Abstract

© 2015 Medical Association of Thailand. All rights reserved. Objective: To evaluate the impact on ovarian reserve between two different methods of hemostasis after laparoscopic ovarian endometrioma excision. Material and Method: A randomized controlled study was conducted from January to December 2013 in Thammasat University Hospital, Thailand. Reproductive women, age 18-45 years who underwent laparoscopic ovarian cystectomy were randomized in electrocoagulation and suture groups. Clinical baseline data and ovarian reserve outcome (anti-Mullerian hormone (AMH)) were evaluated. Results: Fifty participants were recruited and randomized in two groups. Electrocoagulation and suture groups consisted of 25 participants. Baseline characteristics between 2 groups (age, weight, BMI, height, cyst diameter, duration and estimated blood loss) were not statistically different. There were no significant difference of AMH between electrocoagulation and suture group at pre-operative (2.90±2.2±6 vs. 2.52±2.37 ng/ml), 1 week (1.78±1.51 vs. 1.99±1.71 ng/ml), 1 month (1.76±1.50 vs. 2.09±1.62 ng/ml), 3 months (2.09±1.66 vs. 1.96±1.68 ng/ml) and 6 months (2.11±1.84 vs 1.72±1.68 ng/ml), respectively. However, mean AMH of both groups significantly decreased since the first week of operation. Effect of laparoscopic ovarian surgery had significantly declined and sustained AMH level until 6 months. Conclusion: Laparoscopic cystectomy of ovarian endometrioma has negative impact to ovarian reserve. Either electrocoagulation or suture method had no different effects.