الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The biological clock is emerging as one of the most agonizing issues for women in their late thirties and forties in developed countries. Women are anxious to know particularly if they can assess and safely postpone their fertility potential. The removal of ovarian cysts is usually prompted by patient symptoms or by concerns of ovarian malignancy. Rather than excision of the entire ovary, removal of the cyst alone can offer women with suspected benign ovarian pathology an opportunity to preserve hormonal function and reproductive capacity. For these reasons, goals of ovarian cystectomy include gentle handling of tissues to limit postoperative adhesion formation and reconstruction of normal ovarian anatomy to aid the transfer of ova to the fallopian tube. Objectives: The aim of this study is to investigate the impact of electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy in comparison with open ovarian cystectomy.Patients and methods: This study was a prospective control study that was conducted at the Department of Obstetrics and Gynecology in Zagazig University Hospital throughout the period from January 2010 to December 2012. It included 100 attendant of Gynecology outpatient clinic with a diagnosis of ovarian cysts. The patients should be non pregnant premenopausal women aged from (18 years-35 years old) with history sugesstive of ovarian cyst that was confirmed by TVS scanning to determine the characteristics of the lesion. Uni/bilateral ovarian cyst(s) with clinical and sonographic findings suggesting benign nature. Regular menstrual cycles in the 6 months before surgery. All patients were informed about alternative therapeutic approaches, and the patients chose between laparoscopy and an open procedure to remove the cyst(s). For patients who agreed to laparoscopic surgery, bipolar diathermy was used. For patients who did not want to undergo laparoscopic surgery, conventional laparotomic ovarian cystectomy was applied. Those 100 patients were accordingly divided into two study groups; bipolar and suture. Group 1: Bipolar group 50 patients. Group 2: Suture group 50 patients. All patients were subjected to careful history taking, clinical examination, routine preoperative investigations, abdominal ultrasound and TVS. The serum FSH and AMH levels of all the patients enrolled in this study were determined by ELISA on day 3 of the cycle before the surgical procedure. Results: When comparing the bipolar group with the suture group, a statistically significant increase of the mean FSH value was found in bilateral-cyst patients at 1st, 3rd and 6th months follow- up evaluations and in unilateral-cyst patients at the 1st month follow-up evaluation. When comparing the bipolar group with the suture group, a statistically significant decrease of the mean AMH value was found in bilateral-cyst patients at 1st, 3rd and 6th months follow up evaluations and in unilateral-cyst patients at the 1st month follow-up evaluation. Conclusion: The results of our study support the following observations. First, laparoscopic excision of ovarian cysts is associated with a statistically significant reduction in ovarian reserve. Second, the damage cannot be ascribed merely to the amount of ovarian tissue removed during surgery; the damage to the ovarian vascular system by electrocoagulation is another factor.