The effect of bipolar electrocoagulation during ovarian cystectomy on ovarian reserve: a systematic review

• Published in: American journal of obstetrics and gynecology 2015-11, Vol.213 (5), p.620-628
• Main Authors: Pergialiotis, Vasilios, MD, MSc, PhD, Prodromidou, Anastasia, Frountzas, Maximos, Bitos, Konstantinos, Perrea, Despina, PhD, Doumouchtsis, Stergios K., MSc, MPH, PhD, MRCOG
• Format: Article
• Language: English
• Subjects: Anti-Mullerian Hormone - analysis; antimullerian hormone; antral follicle count; bipolar; Cell Count; cystectomy; Electrocoagulation; Female; follicle-stimulating hormone; Humans; Obstetrics and Gynecology; Ovarian Cysts - surgery; Ovarian Follicle - cytology; Ovarian Reserve
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2015.04.006

The aim of the present systematic review was to study the effect of bipolar electrocoagulation during ovarian cystectomy on ovarian reserve. We searched Medline (1966–2015), Scopus (2004–2015), ClinicalTrials.gov (2008–2015), and Cochrane Central Register (CENTRAL) databases along with reference lists of electronically retrieved studies. The levels of antimullerian hormone (AMH) and antral follicle count (AFC) at 1, 3, 6, and 12 months following the excision of the benign ovarian cyst were defined as primary outcomes. Eight studies were finally included in our systematic review, which recruited 545 women. A metaanalysis was precluded because of significant heterogeneity in the methodological characteristics of the included studies. Data from the included studies suggest that the use of bipolar coagulation compared with ovarian sutures seems to result in significantly lower AMH and AFC during the first 3 months following the excision of the ovarian cyst. Two studies reported that this effect seems to persist at 6 and 12 months postoperatively. Bipolar electrodiathermy seems to be accompanied by increased damage to ovarian reserve, which is indicated by the lower levels of AMH and AFC. However, definitive results are precluded because of the significant heterogeneity of included studies and the potential bias.