Influence of ovarian cysts on ovarian reserve and fertility: A case-control study

Int J Gynaecol Obstet. 2024 May;165(2):424-430. doi: 10.1002/ijgo.15284. Epub 2023 Dec 7.

Abstract

Objective: The aim of this study was to evaluate the impact of having an ovarian cyst and undergoing cystectomy on the expression of ovarian reserve markers among adolescent females who live in Armenia.

Methods: We conducted a prospective case-control study. Cases were arranged into two groups. The postoperative group (POG) included those who underwent unilateral ovarian cystectomy, and those in the benign ovarian cyst group (BOCG) had complex ovarian cysts with a diameter of 5 cm or more. Adolescents without ovarian pathologies were included in the reference group (RFG). Levels of anti-Mullerian hormone (AMH) and follicular stimulating hormone (FSH) were measured, and an ultrasound investigation of antral follicular count (AFC) was also done.

Results: Mean differences between baseline and 6-month follow-up levels of AMH, AFC significantly decreased in both the POG and BOCG compared to the RFG. However, the decrease was more significant in the POG: a decrease of 0.86 ng/mL for AMH and 3.11 ng/mL for AFC versus decreasing by 0.61 ng/mL for AMH and 1.68 ng/mL for AFC. Meanwhile, in the BOCG, 6-month FSH levels did not show any significant changes compared to the baseline measurement. In comparison with the reference group, there was a significant decrease in the levels of AMH and AFC among participants who had endometriomas and cystadenomas.

Conclusion: Benign ovarian cysts 5 cm or more in diameter, as well as cystectomy, statistically affect OR after 6 months. Therefore, adolescents with ovarian cyst or cystectomy need individualized support to maintain reproductive age fertility.

Keywords: adolescent females; complex ovarian cyst; ovarian cystectomy; ovarian reserve (OR).

MeSH terms

  • Adolescent
  • Anti-Mullerian Hormone
  • Case-Control Studies
  • Endometriosis* / surgery
  • Female
  • Fertility
  • Follicle Stimulating Hormone
  • Humans
  • Laparoscopy*
  • Ovarian Cysts* / surgery
  • Ovarian Reserve*

Substances

  • Follicle Stimulating Hormone
  • Anti-Mullerian Hormone