Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma. The negative impact on ovarian reserve following removal had been documented. Little evidence had been reported for nonovarian originated effects. Objective. To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve, measured by serum antimullerian hormone (AMH), compared to nonovarian pelvic surgery. Materials and Methods. A prospective study was conducted. Women who underwent laparoscopic ovarian cystectomy (LOC) and laparoscopic nonovarian pelvic surgery (NOS) were recruited and followed up through 6 months. Clinical baseline data and AMH were evaluated. Results. 39 and 38 participants were enrolled in LOC and NOS groups, respectively. Baseline characteristics (age, weight, BMI, and height) and preoperative AMH level between 2 groups were not statistically different. After surgery, AMH of both groups decreased since the first week, at 1 month and at 3 months. However, as compared to the LOC group at 6 months after operation, the mean AMH of the NOS group had regained its value with a highly significant difference. Conclusion. This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve. The possible mechanisms are necessary for more investigations. 1. Introduction Endometriosis, the presence of endometrial tissue outside the lining of the uterine cavity, is one of the most common pelvic diseases in women. It is generally acknowledged that an estimated 6–10% of all women during their reproductive years are affected by this condition. In group of infertility women, 38 percent (20–50%) of them have endometriosis. If the patients have a history of chronic pelvic pain, the prevalence could be as high as 71–87 percent [1–4]. The ovarian endometriosis was recognized by the common term, namely, endometriotic cyst or endometrioma. The surgical intervention, laparoscopy, is the most useful option for further evaluation, treatment, and pathological removal [5]. Moreover, laparoscopic surgery is currently accepted as the procedure of choice for both diagnostic and therapeutic modalities. The systematic reviews showed that the excisional surgery or laparoscopic ovarian cystectomy for endometrioma provided more favorable outcomes than drainage and ablation surgery with regard to the recurrence of the endometrioma, recurrence of pain symptoms [6]. However, there were some reports that showed the negative impact on ovarian reserve, measured by serum antimullerian hormone (AMH) levels
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