Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Nonendometriotic Cyst: The Evaluating Effects on Ovarian Reserve

  • Soheila Sarmadi Department of Pathology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
  • Farahnaz Sadat Ahmadi Mail Department of Pathology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
  • Shahram Ejtemaei Mehr Department of Pharmacology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran Iran.
  • Azizeh Ghaseminejad Department of Obstetrics and Gynecology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
  • Kazem Mohammad Department of Epidemiology and Biostatistics, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Sepideh Nekuie Department of Obstetrics and Gynecology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
  • Soleiman Abbasi Department of Medicine, Health Committee of the Islamic Parliament of Iran, Tehran, Iran.
  • Mehrdad Karimi Department of Epidemiology and Biostatistics, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Fereshteh Gharibpoor Department of Obstetrics and Gynecology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
  • Zahra Elahipanah Department of Radiology, General Women Hospital (Mirza Koochackkhan), Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Non-endometriosis cyst, Cystectomy, Ovarian reserve, Ultrasound, Histopathology, Laparoscopy

Abstract

Currently, laparoscopic cystectomy is the first-line therapy for ovarian benign cysts that are resistant to current therapies. There are different studies that point to ovarian reserve damage due to laparoscopic cystectomy. In this study, we evaluate the ovarian damage following laparoscopic cystectomy for non-endometriosis cysts using ultrasound and pathology findings. This is a prospective cohort study conducted between 7 rd month of 2011 and 10th month of 2012 in Women hospital affiliated to Tehran university of medical sciences.45 non-endometriosis cysts (17 teratoma,7 mucinous, 10 simple serous and 11 simple cysts) underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histopathologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound. AFC after cystectomy for teratoma and simple serous was significantly reduced P<0.05. By larger teratomas and more parenchyma inadvertently removed during their excision (1.64, 0.255) reduced AFC was seen and in simple serous cysts with more removed parenchyma amount (1.5) reduced AFC occurred. In our study simple cysts excision led to a loss in AFC that was not associated with any other cyst parameters. Mucinous cysts resection led to no specific ovarian reserve damage. Laparoscopic cystectomy for non-endometriosis leads to reduced ovarian reserve.

References

Zupi E, Exacoustos C, Szabolcs B, et al. Laparoscopic approach to dermoid cysts Combined surgical technique and ltrasonographic evaluation of residual functioning ovarian tissue. J Am Assoc Gyneco Laparosc 2003;10(2):154-8.

Somigliana E, Ragni G, Infantino M, et al. Does laparoscopic removal of non endometriotic benign ovarian cysts affect ovarian reserve? Acta Obstet Gynecol Scand 2006;85(1):74-7.

Nargund G, Cheng WC, Parsons J. The impact of ovarian cystectomy on ovarian response to stimulation during invitro fertilization cycles. Hum Reprod 1996;11(1):81-3

La Marca A, De Leo V, Giulini S, et al. Anti Mulleian hormone in premenopausal women and after spontaneous or surgically induced menopause. J Soc Gynecol Investig 2005;12(7):545-8.

Hachisuga T, Kawarabayashi T. Histopathological analysis of laparoscopically treated ovarian endometriotic cysts with special reference to loss of follicles. Hum Reprod 2002;17(2):432-5.

Muzii L, Bianchi A, Croce C, et al. Laparoscopic excision of ovarian cysts: is the stripping technique a tissue-sparing procedure? Fertil Steril2002;77(3):609-14.

Tarlatzis BC, Zepiridis L, Grimbizis G, et al. Clinical management of ovarian response to stimulation for IVF:asystematic review. Hum Reprod Update2003;9(1):61-76.

Chan CC, Ng EH, Li CF, et al. Impaired ovarian blood flow andre duced antral follicle count following laparoscopic salpingectomy fore ctopic pregnancy. Hum Reprod 2003;18(10):2175-80.

Ng EH, Yeung WS, Fong DY, et al. Effects of age on hormonal and ultrasound markers of ovarian reserve in Chinese women with proven fertility. Hum Reprod 2003;18(10):2169-74.

Bukman A, Heineman MJ. Ovarian reserve testing and the use ofprognostic models in patients with subfertility. Hum Reprod Update 2001;7(6):581-90.

Lass A, Brinsden P. The role of ovarian volume in reproductive medicine. Hum Reprod Update 1999;5(3):256-66.

Bancsi LF, Broekmans FJ, Eijkemans MJ, et al. Predictors of poor ovarian response in in vitro fertilization: aprospective study comparing basal markers of ovarian reserve. Fertil Steril 2002;77(2):328-36.

Matsouzaki S, Houlle C, Darcha S, et al. Analysis of risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis. Hum Reprod 2009;24(6):1402–6.

Garcia-Velasco JA, Somigliana E. Management of endometriomas in women requiring IVF: to touch or not to touch. Hum Reprod 2009;24(3):496-501.

Loh FH, Tan AT, Kumar J, et al. Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles. Fertil Steril 1999;72(2):316-21.

Ho HY, Lee RK, Hwu YM, et al. Poor response of ovaries with endometrioma previously treated with cystectomy to controlled ovarian hyperstimulation. J Assist Reprod Genet 2002;19(11):507-11.

Exacoustos C, Zupi E, Amadio A, et al. Laparoscopic removal of endometriomas:sonographic evaluation of residual functioning ovarian tissue. Am J Obstet Gynecol 2004;191(1):68-72.

Donnez J, Nisolle M, Gillet N, et al. Large ovarian endometriomas. Hum Reprod 1996;11(3):641-6.

Matsouzaki S, Houlle C, Darcha S, et al. Analysis of risk factors for the removal of normal ovarian tissue during laparoscopic cystectomy for ovarian endometriosis. Hum Reprod 2009;24(6):1402-6.

Maneschi F, Marasa L, Incandela S, et al. Ovarian cortex surrounding benign neoplasms: a histologic study. Am J Obstet Gynecol 1993;169(6):388-93.

Dogan E, Ulukus EC , Okyay E , et al. Retrospective analysis of follicle loss after laparoscopic excision ofendometrioma compared with benign nonendometriotic ovarian cysts. Int J Gynecol Obstet 2011;114(2):124-7.

How to Cite
1.
Sarmadi S, Ahmadi FS, Ejtemaei Mehr S, Ghaseminejad A, Mohammad K, Nekuie S, Abbasi S, Karimi M, Gharibpoor F, Elahipanah Z. Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Nonendometriotic Cyst: The Evaluating Effects on Ovarian Reserve. Acta Med Iran. 52(5):341-344.
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