Evaluation of reproductive function in patients after using different hemostatic techniques (fibrin glue and bipolar coagulation) during ovarian surgery

Ibragimova U.D., Kozachenko I.F., Kozachenko A.V., Strelnikova E.V., Adamyan L.V.

1) V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) Russian University of Medicine, Ministry of Health of the Russia, Moscow, Russia

Ovarian-sparing surgery in women of reproductive age involves surgical removal of benign tumors and maximum preservation of the ovarian follicular reserve. However, laparoscopic ovarian cystectomy can lead to the damage of healthy ovarian tissue and decline in ovarian reserve. The choice of the hemostatic technique significantly influences the degree of postoperative changes. In recent years, particular attention has been paid to the technologies that reduce heat stress on ovarian tissue and, as a result, improve reproductive outcomes.
Objective. To evaluate reproductive function in patients after the use of different hemostatic techniques during ovary-sparing surgery. 
Materials and methods. The study included 164 women aged 18–45 years with benign, cystic ovarian tumors (mature teratomas and cystadenomas), who underwent surgery at the Gynecological Department of V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia from 2022–2024. Based on the intraoperative technique for hemostasis, two groups were formed: group 1 – fibrin glue (n=86) and group 2 – bipolar coagulation (n=78). The effect of using these techniques on reproductive function was evaluated within 12 months after surgical treatment.
Results. The duration of surgery was comparable between the groups. However, the use of fibrin glue was accompanied by less blood loss and faster achievement of surgical hemostasis. Intraoperative blood loss with the use of fibrin glue was significantly lower compared to bipolar coagulation. Pregnancy rate within 12 months of follow-up was significantly higher in group 1 – 86.5% of patients became pregnant, and 65.9% of patients in group 2 (p=0.017). At the same time, spontaneous pregnancy was also registered more often in group 1 – in 59.6% of women compared to 38.6% of women in group 2 (p=0.039). The groups did not differ significantly in the need for assisted reproductive technologies. Pregnancy rate among the patients with initial infertility in group 1 was 81.8%, and 55.6% in group 2 (p=0.03).
Conclusion. Surgical hemostasis has a significant impact on reproductive outcomes after ovarian-sparing surgery. The use of fibrin glue is associated with significantly favorable restoration of reproductive function compared to bipolar coagulation.

Authors' contributions. Adamyan L.V., Kozachenko I.F. – the study concept and design; Ibragimova U.D., Kozachenko I.F., Kozachenko A.V., Strelnikova E.V. – material collection and processing; Ibragimova U.D., Kozachenko I.F., Kozachenko A.V. – statidstical data analysis; Ibragimova U.D., Kozachenko I.F. – manuscript writing; Adamyan L.V. – manuscript editing.
Conflicts of interest. The authors confirm that they have no conflict of interest to declare.
Funding. The study was carried out without external sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator. 
For citation: Ibragimova U.D., Kozachenko I.F., Kozachenko A.V., Strelnikova E.V., Adamyan L.V. 
Evaluation of reproductive function in patients after using different hemostatic techniques
(fibrin glue and bipolar coagulation) during ovarian surgery.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (8): 129-133 (in Russian)
https://dx.doi.org/10.18565/aig.2026.143

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About the Authors

Ummusalimat D. Ibragimova, PhD student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, amintaeva_umm@mail.ru, https://orcid.org/0009-0008-6984-7193
Irena F. Kozachenko, Dr. Med. Sci., Leading Researcher, obstetrician-gynecologist, Gynecological Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, irenakozachenko@rambler.ru,
https://orcid.org/0000-0003-1822-9164
Andrey V. Kozachenko, Dr. Med. Sci., Professor of the Russian Academy of Sciences, Leading Researcher, obstetrician-gynecologist, Gynecological Department,
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation,
117997, Russia, Moscow, Ac. Oparin str., 4, a_kozachenko@oparina4.ru, https://orcid.org/0000-0002-5573-6694
Elena V. Strelnikova, PhD, physician of the highest category, transfusion specialist, obstetrician-gynecologist, Department of Extracorporeal Treatment and Detoxification Methods, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation,
117997, Russia, Moscow, Ac. Oparin str., 4, e_strelnikova@oparina4.ru, https://orcid.org/0000-0002-6926-8414
Leila V. Adamyan, Academician of the Russian Academy of Sciences, Dr. Med. Sci., Professor, Deputy Director for Research, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4; Chief Specialist
in Gynecology of the Ministry of Health of Russia; Head of the Department of Reproductive Medicine and Surgery of the Faculty of Postgraduate Education, Russian University of Medicine, adamyanleila@gmail.com, https://orcid.org/0000-0002-3253-4512
Corresponding author: Ummusalimat D. Ibragimova, amintaeva_umm@mail.ru

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