The present study was performed to diagnose and treat ovarian cysts with either hormonal treatment or laparoscopic surgery. Thirty-four lactating dairy cows were divided after ultrasonographic examination into two main groups: Cows in group 1(with follicular cyst, n=20) were treated by administration of gonadotrophin releasing hormone (GnRH) at a one
dose of 5 ml/im/cow. Fourteen cows were responded and assigned as group “1a" while the non-responders (6 animals) were assigned as group “1b". Cows in group 2 (with luteal cyst, n=14) were treated by the administration of two doses of prostaglandin f2α each 2 ml/im/cow with11 days interval.Based on results of ultrasonographic examination, 10 cows responded and assigned as group ‘2a', and 4 were non-responding cows represent group ‘2b'. Animals belonging to 1b and 2b groups were treated with surgical laparoscopic interference via a left flank approach. The cysts were aspirated (follicular) or removed by bipolar cauterization (luteal) in standing cows with sedation and local anesthesia. Blood samples were collected from the jugular vein in plain vacuum tubes and centrifuged at 3000 rpm for 15 min. Serum was separated and stored at -20oC till hormonal and cytokines assays. The results obtained showed that values of TNF-α and IL-6 were significantly higher (P<0.01) in cystic cows with follicular and luteal cyst non-responded to hormonal treatment compared to those with cyclic ovarian cows. A high level of 17β-estradiol with concurrent low levels of progesterone showed in follicular cystic cows non-responded compared to responded cows. The significant drop in serum 17 β estradiol and high levels of progesterone in non-responded luteal cystic cows compared to responded cows. Significant decrease (p<0.01) in serum level of both insulin and IGF-1 in cows non-responded to hormonal treatment compared to responded ones. The results revealed that percentage of conception rates at first AI in laparoscopic surgical treated cows was higher than hormonal treated cows. Based on the obtained results, measuring TNF-α, IL-6, insulin and IGF-I could predict the response to hormonal therapy. In addition, it is recommended to apply the laparoscopic approach for the non-responding cases of follicular and luteal ovarian cysts