Ovarian reserve after three‐step laparoscopic surgery for endometriomas utilizing dienogest: A pilot study

Michio Kitajima, Kanako Matsumoto, Naoko Murakami, Ayumi Harada, Yuriko Kitajima, Hideaki Masuzaki, Kiyonori Miura
In: Reproductive Medicine and Biology · 2020 · vol. 19(4) , pp. 425–431 · doi:10.1002/rmb2.12349 · W3087056854
article OA: gold CC0 ⤵ 14 in-corpus citations
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Abstract

Abstract Purpose Surgery for endometriomas may cause detrimental effects on ovarian reserve. We evaluated the safety of three‐step laparoscopic surgery for endometriomas utilizing dienogest in terms of post‐surgical ovarian reserve. Methods Twelve women received first look laparoscopy (FLL) with fenestration and drainage. Immediately after the surgery, they took oral dienogest 2 mg for three months; then, they received second look laparoscopy (SLL) with cystectomy. We compared serum AMH levels between women had three‐step management with dienogest, and another twelve women had conventional one‐step surgery without medications. In women had three‐step procedures, the changes in concentration of proinflammatory cytokines and chemokines in peritoneal fluids were evaluated. Results Serum AMH levels were significantly decreased after three months of dienogest following FLL. AMH levels were also significantly decreased 3‐6 months both after SLL and after one‐step surgery; however, recovery of serum AMH levels at 9‐12 months after surgery was evident in women had three‐step surgery comparing to those of one‐step surgery. Proinflammatory cytokines and chemokines in peritoneal fluids were downregulated at the time of SLL comparing to those of FLL. Conclusions Three‐step surgery with dienogest may be a beneficial approach to protect ovarian reserve. Dienogest may exert its effects in part by lowering proinflammatory cytokines and chemokines.

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SciLite annotations

chemicals 40
dienogest dienogest dienogest dienogest dienogest dienogest dienogest dienogest dienogest progestin progestin dienogest dienogest estradiol dienogest progestin dienogest dienogest progestin progestin dienogest dienogest dienogest estrogen progestin dienogest dienogest dienogest dienogest dienogest dienogest progesterone dienogest dienogest dienogest dienogest dienogest dienogest dienogest progestin
organisms 10
noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 noordeloos 2009062 human human

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