title: Impact of Cystectomy on Ovarian Reserve: Review of the Literature.
abstract: Ovarian cysts are common in the reproductive age. Pathologic cysts such as endometriomas and dermoids often require surgical intervention if symptomatic. Laparoscopic cystectomy is the first-line treatment for these cysts and is associated with better pain control and less recurrence than drainage or cyst ablation procedures. There has been an emerging concern about the effect of ovarian cystectomy on ovarian reserve with some evidence of short-term and long-term reduction in ovarian reserve. Certain cyst characteristics (endometrioma pathology, large cyst size, bilateral presentation) are associated with a greater decline in ovarian reserve after cystectomy. The impact of surgery on ovarian reserve can be minimized by selecting the appropriate surgery for the patient, careful tissue handling, and limited use of electrosurgery. Patients should be counseled on the risks of surgery on reproductive potential, and the management plan should be individualized to the patient's symptoms and reproductive goals.
authors.affiliation: Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Roa
authors.initials: R
authors.lastname: Alammari
authors.affiliation: Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michelle
authors.initials: M
authors.lastname: Lightfoot
authors.affiliation: Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address: hhur@bidmc.harvard.edu.
authors.forename: Hye-Chun
authors.initials: HC
authors.lastname: Hur
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods; D059351:Organ Sparing Treatments / Q000379:methods; D010048:Ovarian Cysts / Q000473:pathology / Q000601:surgery; D065851:Ovarian Reserve; D010052:Ovariectomy / Q000009:adverse effects / Q000379:methods; D010053:Ovary / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D060728:Reproductive Health
keywords: Cyst ablation; Cyst stripping; Dermoids; Endometriomas; Infertility; Ovarian cystectomy; Ovarian cysts; Ovarian reserve; Ovarian-sparing surgery