The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas

Ovarian reserve is negatively affected by laparoscopic cystectomy of endometriomas demonstrated by decreased antim€ullerian hormone and increased FSH levels, especially in those older than 38 years and with bilateral cysts.

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Authors

Saeed Alborzi, M.D., Pegah Keramati, M.D., Masoomeh Younesi, M.D., Alamtaj Samsami, M.D., Nasrin Dadras, M.D.

Volume 101, Issue 2, Pages 427-434, February 2014

Abstract

Objective:

To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas.

Design:

Prospective study.

Setting:

Private and university hospitals.

Patient(s):

A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy.

Intervention(s):

Serum levels of antimüllerian hormone (AMH), FSH, and E2, as well as antral follicle count (AFC) were measured preoperatively and 1 week, 3 and 9 months postoperatively for AMH, and 3 months for other values.

Main Outcome Measure(s):

Ovarian reserve based on the comparison of AMH alterations. The secondary end points are changes in FSH, E2, and AFC.

Result(s):

Serum AMH level decreased significantly from the baseline (3.86 ± 3.58 ng/mL) to 1 week (1.66 ± 1.92 ng/mL), 3 months (2.06 ± 2.5 ng/mL), and 9 months (1.77 ± 1.76 ng/mL) postoperatively. Those patients with bilateral endometriomas had significantly lower levels of AMH, 1 week, 3 and 9 months after operation. Also, patients older than 38 years had lower postoperative AMH levels. The FSH levels increased significantly from baseline to 3 months postoperatively. The AFC level increased significantly from baseline to 3 months after operation.

Conclusion(s):

The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas, especially in older patients and those with bilateral cysts.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)03165-8/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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