{"paper_id":"69c8272c-5bb4-4283-a6c4-d55be3d9e133","body_text":"Abstract\nThis study aimed to compare the impact of ablation and cystectomy for ovarian endometrioma on ovarian reserve, recurrence rates, and pregnancy rates. Databases were searched for studies reporting ovarian reserve (measurement of anti-müllerian hormone [AMH] only), recurrence rates, and/or pregnancy rates after cystectomy and ablation for ovarian endometrioma. Six randomized clinical trials and five prospective cohort studies were included in this meta-analysis. All included studies had a low risk of bias. After ablation, weighted mean difference (WMD) between post- and pre-operative AMH values was − 0.40 (95% confidence interval [CI]: -0.61 to -0.19, p = 0.0002, I2 = 0%). After cystectomy, the WMD of AMH was − 1.08 (95% CI: -1.34 to -0.82, p < 0.00001, I2 = 48%). The intergroup comparison revealed that pre-operative AMH values were similar between the two groups, but post-operative AMH was significantly higher in the ablation group (WMD: 0.38, 95% CI: 0.13 to 0.63, p = 0.003, I2 = 3%). Subgroup analysis showed that the favorable effects of ablation compared to cystectomy are evident after three months of operation, in a bilateral setting, or with the laser ablation method. Overall recurrence rate (risk ratio [RR]: 1.51, 95% CI: 1.08 to 2.12, p = 0.02, I2 = 0%) and one-year recurrence rate (RR: 2.36, 95% CI: 1.30 to 4.31, p = 0.005, I2 = 0%) were significantly higher in the ablation group than in the cystectomy group. Pregnancy rates were similar between the two groups (odds ratio: 1.18, 95% CI: 0.92 to 1.52, p = 0.20, I2 = 72%). These results demonstrate that ablation could result in a smaller serum AMH decrement than cystectomy, but the recurrence rate could be higher after ablation.\nSimilar content being viewed by others\nData Availability\nNot applicable.\nCode Availability\nNot applicable.\nChange history\n03 April 2024\nA Correction to this paper has been published: https://doi.org/10.1007/s43032-024-01528-5\nReferences\nD’Hooghe TM, Debrock S, Hill JA, Meuleman C, editors. Endometriosis and subfertility: is the relationship resolved? Semin Reprod Med. 2003.\nBarnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril. 2002;77:1148–55.\nKitajima M, Defrère S, Dolmans M-M, Colette S, Squifflet J, Van Langendonckt A, et al. Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis. Fertil Steril. 2011;96:685–91.\nKasapoglu I, Ata B, Uyaniklar O, Seyhan A, Orhan A, Oguz SY, et al. 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Cochrane Database Syst Rev. 2016.\nAcknowledgements\nNot applicable.\nFunding\nNot applicable.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nEthics Approval\nApproval for the institutional review board (IRB) for this research is not required since this is a meta-analysis not directly involving clinical data.\nConsent to Participate\nNot applicable.\nConsent for publication\nNot applicable.\nCompeting Interests\nAll authors declare no conflict of interest.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nElectronic Supplementary Material\nBelow is the link to the electronic supplementary material.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nPaik, H., Jee, B.C. Impact of Ablation Versus Cystectomy for Endometrioma on Ovarian Reserve, Recurrence, and Pregnancy: An Updated Meta-Analysis. Reprod. Sci. 31, 1924–1935 (2024). https://doi.org/10.1007/s43032-024-01512-z\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-024-01512-z","source_license":"CC0","license_restricted":false}