【Abstract】 ObjectiveTo explore the effects of hemostasis by bipolar coagulation and suture during laparoscopic cystectomy for ovarian endometrioma on ovarian reserve, thus to provide evidence for the hemostasis choice during laparoscopic cystectomy for ovarian endometrioma . MethodsA total of 180 patients undergoing laparoscopic unilateral cystectomy for ovarian endometrioma were randomly divided into suture group and coagulation group, with 90 cases in each group. Hemostasis by suture and bipolar coagulation were performed in the suture group and coagulation group respectively. The intraoperative blood loss, operative duration and postoperative exhaust time were compared between the two groups. The serum levels of follicle stimulating hormone(FSH), estradiol (E2), luteinizing hormone (LH) and antiMullerian hormone (AMH) were detected in the patients. The bilateral ovarian volume (OV), the peak systolic value (PSV) of ovarian stromal blood flow and antral follicle count (AFC) were measured . ResultsThe intraoperative blood loss, operative duration of the suture group were significantly more or longer than those of the coagulation group (P＜0.05). In both groups, the serum FSH and LH levels significantly increased but the E2 and AMH levels significantly decreased after operation compared to the preoperative levels (P＜0.05). At the first and sixth months after operation, the serum FSH and LH levels were significantly higher but the E2 and AMH levels were significantly lower in the coagulation group compared to the group (P＜0.05). At the first and sixth months after operation, the OV, PSV and AFC of the affected sides decreased in both groups compared to the normal sides (P＜0.05), and these indices also significantly increased in the suture group compared to the coagulation group(P＜0.05). ConclusionLaparoscopic cystectomy for ovarian endometrioma can cause impaired ovarian reserve. Compared to hemostasis by coagulation, hemostasis by suture has less effect on the ovarian reserve.

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