{"paper_id":"750f2b06-c761-4e85-9663-b39d06afae49","body_text":"Previously submitted to: Interactive Journal of Medical Research (no longer under consideration since Oct 21, 2024)\nDate Submitted: Jan 28, 2024\nOpen Peer Review Period: Jan 30, 2024 - Mar 26, 2024\n(closed for review but you can still tweet)\nNOTE: This is an unreviewed Preprint\nWarning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note \"no longer under consideration\" will appear above).\nPeer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a \"Peer Review Me\" button to sign up as reviewer is displayed above). 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Preprints - unless they show as \"accepted\" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.\nImpact of Endometrioma Surgery on Fertility: A Prospective Cohort Study\nABSTRACT\nBackground:\nEndometrioma is often associated with infertility. While cystectomy can improve the pregnancy rate, it may also affect the ovarian reserve.\nObjective:\nThis study aimed to investigate the impact of endometrioma cystectomy on ovarian reserve markers at 3 and 12 months after surgery in infertile women and to determine the postoperative pregnancy rate.\nMethods:\nThis prospective, longitudinal, monocentric cohort study included 40 infertile patients aged 21–40 years with ovarian endometriomas measuring ≥4 cm in diameter and with good tubal patency and normal spermogram test results of the husband at the Gharafa Clinic, a gynecological and obstetric clinic annexed to the Bab El Oued University Hospital in Algiers. The main outcome measures were ovarian reserve (Antral Follicle Counts [AFC] follicle-stimulating hormone [FSH], and anti-Müllerian hormone [AMH] levels). We also calculate the number of follicles retrieved from cysts to evaluate their impact on the ovarian reserve and the spontaneous pregnancy rate.\nResults:\nAfter endometrioma cystectomy, the antral follicle count significantly increased at 12 months postoperatively (7.7±0.6 follicles before surgery vs. 8.5±0.5 follicles after surgery, p<0.001). The mean FSH levels did not increase; however, the AMH levels significantly decreased at 3 and 12 months postoperatively (2.29±0.26 ng/mL before surgery vs. 1.47±0.23 ng/mL at 3 months, p<0.001 and 1.46±0.20 ng/mL at 12 months, p<0.001). After stratification into three groups, decreased AMH levels after surgery showed a significant association with cystectomy associated with other surgical procedures, particularly in the presence of deep endometriosis. The number of follicles retrieved from cysts correlated with AMH levels preoperatively, but not postoperatively. Overall, 47.5% of patients had spontaneous pregnancies despite having low AMH levels; hence, surgery was considered to be effective.\nConclusions:\nCystectomy can reduce the AMH level in cases of associated endometrioma but not in isolated endometrioma, the CFA increase and FSH doesn’t change. In fact this cystectomy can improve spontaneous pregnancy in half of cases.\nCitation\nRequest queued. Please wait while the file is being generated. It may take some time.\nCopyright\n© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.","source_license":"CC0","license_restricted":false}