Does laparoscopic removal of nonendometriotic benign ovarian cysts affect ovarian reserve?

Background. The objective of this study was to investigate whether laparoscopic excision of nonendometriotic benign ovarian cysts is associated with a significant injury to ovarian reserve. Methods. Women selected for IVF-ICSI cycles who previously underwent laparoscopic excision of a monolateral nonendometriotic benign ovarian cyst were retrospectively identified. The operated ovary and the contralateral intact gonad of the same patient were compared in term of basal ovarian volume before initiating ovarian stimulation and number of dominant follicles at the time of human chorionic gonadotropin administration. Non-parametric Wilcoxon Rank test was used to investigate differences between the two ovaries. Results. Seventeen cases were recruited. The numbers of dominant follicles were 4.6 +/- 2.5 and 2.7 +/- 2.4 in the control ovary and in the previously operated ovary, respectively ( p = 0.01). This drop corresponded to a mean reduction of 42% (95% confidence interval: 10 - 74%). Basal volumes of the intact and the operated gonads were 5.7 +/- 3.3 and 3.4 +/- 2.3 cm(3) respectively ( p = 0.01), corresponding to a mean reduction of 39% ( 95% confidence interval: 12 - 66%). Conclusions. Laparoscopic excision of nonendometrioid benign ovarian cysts is associated with a significant injury to ovarian reserve.