Fertility-enhancing ovarian cystectomy

Ovarian cysts are a frequent surgical diagnosis in women of reproductive age. While most ovarian cysts in this age group are benign, a careful preoperative evaluation will identify those who would benefit from surgical intervention and, furthermore, when referral to a gynecologic oncologist may be warranted. The most common cysts encountered in women of reproductive age include simple cysts, serous or mucinous cystadenomas, endometriomas, and mature cystic teratomas. Important aspects of a preoperative evaluation to assist in evaluating for a potentially malignancy ovarian mass include a detailed medical history, physical examination, imaging studies, and laboratory evaluation. Fertility-sparing ovarian cystectomy, typically performed laparoscopically, can be offered to women with benign ovarian cysts who desire future fertility. Prior to ovarian cystectomy, women should be counseled regarding the potential impact on ovarian reserve.