Surgical Technique and Fertility Outcomes: A Comprehensive Review of Open and Laparoscopic Cystectomy in Women of Reproductive Age

Cystectomy, the surgical removal of ovarian tissue, is commonly performed in women of reproductive age to address conditions such as ovarian cysts, endometriosis, and tumors. The choice of surgical technique, open versus laparoscopic, has significant implications for postoperative recovery and long-term fertility outcomes. This comprehensive review aims to evaluate the current literature on the effects of these two surgical approaches on fertility in women of reproductive age. Open cystectomy, while effective, is associated with larger incisions, increased trauma to surrounding reproductive structures, and a higher incidence of postoperative complications, which may negatively impact future fertility. In contrast, laparoscopic cystectomy offers a minimally invasive option that generally results in less postoperative pain, quicker recovery, and potentially improved fertility outcomes due to reduced damage to surrounding tissues. However, the literature reveals a complex interplay between surgical technique, underlying medical conditions, and individual patient factors that can influence reproductive potential. This review synthesizes key studies comparing the fertility outcomes of both surgical methods, highlighting the need for individualized surgical planning based on each patient's unique circumstances and reproductive goals. Additionally, it discusses the importance of preoperative counseling and multidisciplinary approaches to optimize patient outcomes. Future research is essential to further clarify the long-term fertility implications of open and laparoscopic cystectomy and to refine surgical techniques to enhance reproductive health. This review contributes to the growing body of evidence guiding clinicians in making informed decisions that prioritize the effective treatment of ovarian pathology and fertility preservation.