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

Capsule:
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.

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.

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