Ovarian damage after laparoscopic endometrioma excision might be related to the size of cyst

Capsule:
Ovarian damage after laparoscopic endometrioma excision is more severe in ovaries from which an endometrioma 4 cm in diameter has been excised.

Authors:
Yan Tang, M.D., M.Sc., Shiling Chen, M.D., Ph.D., Xin Chen, M.D., M.Sc., Yuxia He, M.D., Desheng Ye, M.D., Ph.D., Wei Guo, M.D., Haiyan Zheng, M.D., Ph.D., Xinhong Yang, M.D., Ph.D.

Volume 100, Issue 2, Pages 464-469, August 2013

Abstract:

Objective:
To investigate the relationship between the size of an excised endometrioma and the magnitude of damage to the ovary after the surgery.

Design:
A retrospective, controlled study.

Setting:
A university hospital.

Patient(s):
Eighty-five women with a history of laparoscopic excision of unilateral endometrioma who underwent in vitro fertilization (IVF).

Intervention(s):
IVF-embryo transfer procedures.

Main Outcome Measure(s):
Antral follicle counts (AFC), number of dominant follicles (follicles ≥15 mm), and number of oocytes retrieved.

Result(s):
In the group with cyst diameters of ≥4 cm and group with cyst diameters of <4 cm, the AFC, number of dominant follicles, and number of oocytes retrieved were decreased in the operated ovaries when compared with those in intact ovaries; in the former group, a statistically significant reduction was observed. The differences of AFC, number of dominant follicles, and number of oocytes retrieved from both ovaries were further compared among the two groups: the decrease in the group with cyst diameters of ≥4 cm was higher than in the group with cyst diameters of <4 cm. After adjusting for age and AFC in intact ovaries, similar results were obtained, although AFC only showed a tendency. In addition, the receiver operating characteristic curve analysis revealed a statistically significant, positive correlation between the size of excised cysts and the incidence of fewer than four oocytes retrieved from an operated ovary. Conclusion(s):
The magnitude of the ovarian damage after laparoscopic endometrioma excision might be related to the size of cyst; the damage to ovaries is more severe when an endometrioma ≥4 cm is excised.

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