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Updated: Aug 22, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles
1Department of Obstetrics and Gynaecology, National University of Singapore, Singapore. obglohfh@nus.edu.sg
Objective:
To investigate the follicular response of ovaries after laparoscopic ovarian cystectomy for endometriotic cysts.
Design:
A retrospective, controlled study.
Setting:
Obstetrics and Gynaecology Department of a university hospital.
Patient(S):
Patients with history of infertility who had laparoscopic ovarian cystectomy for endometriotic cysts.
Intervention(S):
Laparoscopic ovarian cystectomy, transvaginal ultrasound monitoring of follicles in natural cycles, stimulated cycles using clomiphene citrate (CC), chronic low-dose FSH, and "flare down" regimen.
Main Outcome Measure(S):
Follicular response of postcystectomy and normal ovaries.
Result(S):
For women < 35 years of age, the mean follicular response of postcystectomy ovaries was reduced significantly when compared with normal ovaries in natural cycles (0.30 versus 1.00 follicle per cycle) and in CC-stimulated cycles (0.87 versus 1.27 follicles per cycle). The mean follicular response was not statistically significantly different when the ovaries were stimulated with chronic low-dose FSH or with the flare down regimen. For women > or = 35 years, postcystectomy ovaries responded with a comparable number of follicles as the normal ovaries in natural cycles and the three different ovarian stimulation regimens.
Conclusion(S):
Postcystectomy ovaries showed reduced follicular response in natural and CC-stimulated cycles for women < 35 years of age. Postcystectomy ovaries produced a comparable number of follicles as normal ovaries when stimulated with gonadotropins.
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