Objectives: To assess the diagnostic accuracy of transvaginal ultrasound, aspiration cytology and estradiol content alone
and in triad in the discrimination between functional and nonfunctional unilocular ovarian cysts in premenopausal
women. Methods: Premenopausal women (n;;; 18) with unilocular ovarian cysts undergoing laparoscopy were recruited.
Intracystic fluid was obtained by needle aspiration and subjected to cytology and estradiol content. The cyst wall that
was removed during laparoscopy/laparotomy was subjected to histopathology as a gold standard. Cysts were classified
into functional or non-functional according to the results of transvaginal ultrasonography, cytology and estradiol
content. Results: The diagnostic accuracy of transvaginal sonography was 61 %, cytology 72 %.and estradiol content 83 % in differentiating unilocular ovarian cysts into functional and non-functional. When the triad was used in combination, the diagnostic accuracy was increased to 94 %. Conclusion: Aspiration of unilocular ovarian cysts based on assessment by transvaginal ultrasound alone may not be sufficient. The addition of cytology and estradiol content increased the diagnostic accuracy. This triad can reduce the number of unnecessary laparotomies especially in young subfertile women.