Background Laparoscopic ovarian cystectomy is widely used for benign cysts, but the stripping technique and bipolar energy for hemostasis may disturb ovarian reserve. This concern becomes more pointed in young women who have not completed childbearing. Objectives To quantify changes in serum anti‑Müllerian hormone (AMH) and antral follicle count (AFC) after laparoscopic cystectomy, and to explore whether cyst histology and cautery exposure relate to the magnitude of change. Methods A prospective observational study enrolled 50 women aged 18–35 years undergoing laparoscopic cystectomy for benign ovarian cysts (3–8 cm). AMH and AFC (cycle day 2/3 transvaginal ultrasound) were measured preoperatively and at 3 and 6 months postoperatively. Paired t‑tests compared follow-up values with baseline; one‑way ANOVA compared cyst‑type subgroups; Pearson correlation assessed association between cautery time and AMH reduction. Results Mean AMH declined from 3.54±0.88 ng/mL preoperatively to 2.32±0.68 ng/mL at 3 months (p <0.001), with partial recovery at 6 months (2.75±0.73 ng/mL; p <0.001 vs baseline). AFC changed in the same direction (baseline 13.70±3.41, 3 months 9.70±4.32, 6 months 11.52±4.03; all p<0.001). AMH reduction at 3 months differed by cyst type (ANOVA p=0.0049) and correlated with cautery time (r=0.51, p<0.001). Conclusions Laparoscopic cystectomy was followed by a significant early decline in ovarian reserve markers, with incomplete recovery by 6 months. Endometriotic cysts and higher cautery exposure were linked to larger early AMH reduction, highlighting the importance of fertility‑sparing surgical technique and counselling.

Anti‑Müllerian Hormone, Antral Follicle Count, Laparoscopic Cystectomy, Ovarian Reserve, Endometrioma, Bipolar Coagulation