Intravenous Tranexamic Acid Possible Effects on Ovarian Reserve during Laparoscopic Cystectomy of Endometrioma: Double Blind Randomized Controlled Trial

Mohamed El-Hussieny ElKoddosy, Anwar Ezzat Ismail, Howaida Hussieny Abo-Zaid Salem, Ahmed Ismail Mohamed
In: The Egyptian Journal of Hospital Medicine · 2023 · vol. 91(1) , pp. 4305–4310 · doi:10.21608/ejhm.2023.296208 · W4366832326
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Intravenous tranexamic acid administration reduced blood loss and preserved ovarian reserve, as indicated by higher AMH levels post-surgery, during laparoscopic endometrioma cystectomy.

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Abstract

Background: Numerous gynecologists look for ways to protect ovarian health. To lessen the risk of blood loss, surgeons sometimes prescribe tranexamic acid (TXA). Objective: The aim of the current work was to examine the potential benefit of tranexamic acid on ovarian reserve and intraoperative blood loss, by comparing the mean differences in anti-müllerian hormone (AMH) levels before and after laparoscopic ovarian cystectomy. Subjects and Methods: A total of 30 women had ovarian endometriomas were included in the study, the laparoscopic cystectomy was done for ovarian endometriomas in the Endoscopic Unit in Zagazig University Hospitals. They were categorized randomly into two groups; Group I (control): consisted of 15 patients who were subjected to intravenous administration of 110 ml of normal saline preceding the incision of the skin. Group II: consisted of 15 patients who were subjected to intravenous administration of 1 g tranexamic acid (2 kapron 500 mg 5 ml ampoules) preceding the incision of the skin. Results: There was a substantial difference between the study group and the control group regarding intraoperative, postoperative, and total blood loss. Postoperative serum AMH at one and six months later after the operation showed significant reported differences, that were higher in Group II. There was a highly statistically significant difference between the studied groups regarding operative time, hospital stay being higher among control group. Conclusion: The current study's findings lend credence to the hypothesis that reducing the risk of ovarian reserve loss after laparoscopic cystectomy for endometrioma is facilitated by intravenous TXA administration.

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endometrioma

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