Influence of Cyst Size on Ovarian Reserve after Unilateral Laparoscopic Ovarian Cystectomy for Endometrioma and Ovarian Mature Teratoma

Heesuk Chae
In: Journal of Surgery and Research · 2023 · vol. 06(01) · doi:10.26502/jsr.10020284 · W4361799128
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This study found that laparoscopic cystectomy for endometriomas causes greater ovarian reserve loss than for mature teratomas, with cyst size significantly correlating with reduced anti-Müllerian hormone levels only in the teratoma group.

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This retrospective study evaluated the impact of ovarian cyst size on postoperative serum anti-Müllerian hormone levels in women undergoing unilateral laparoscopic cystectomy for either endometriomas or mature teratomas. The researchers analyzed eighty-one patients and found that the decline in ovarian reserve was significantly greater following surgery for endometriomas compared to teratomas. While cyst diameter correlated with reduced ovarian reserve in patients with mature teratomas, no such association was observed in the endometrioma group. This paper is centrally about endometriosis — specifically assessing how surgical removal of endometriomas affects ovarian reserve markers compared to benign teratomas.

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Abstract

Background: The present study is aimed to investigate the influence of ovarian cyst size on serum anti-Müllerian hormone levels after laparoscopic ovarian cystectomy in women with endometrioma and ovarian mature teratoma. Methods: From March 2017 to December 2018, we retrospectively studied eighty-one patients who underwent unilateral laparoscopic cystectomy for endometrioma (n = 41, endometrioma group) and ovarian mature cystic teratoma (n = 40, teratoma group). Serum anti-Müllerian hormone (AMH) levels were measured preoperatively and 1 month after surgery. Results: The rate of decrease in serum AMH levels after laparoscopic cystectomy was significantly higher in the endometrioma group than in the teratoma group (0.35 ± 0.04% vs. 0.19 ± 0.04%, p = 0.013). In patients with mature cystic teratoma, a statistically significant correlation between the rate of decrease in serum AMH levels and cyst size was observed (r = 0.391, p = 0.013); the rate of decrease in serum AMH levels after surgery was significantly higher in the > 5.13 cm subgroup than in the ≤ 5.13 cm subgroup (p = 0.006). Conclusions: Laparoscopic cystectomy for endometriomas may result in a more significant damage to the ovarian reserve compared with that for ovarian mature cystic teratomas. Cyst diameter and reduced ovarian reserve after surgery were not correlated in patients with endometriomas, whereas a significant correlation was observed in patients with ovarian mature teratomas. The decrease in AMH levels was more evident in patients with a mature teratoma > 5.13 cm.
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Abstract

Background: The present study is aimed to investigate the influence of ovarian cyst size on serum anti-Müllerian hormone levels after laparoscopic ovarian cystectomy in women with endometrioma and ovarian mature teratoma.

Methods

From March 2017 to December 2018, we retrospectively studied eighty-one patients who underwent unilateral laparoscopic cystectomy for endometrioma (n = 41, endometrioma group) and ovarian mature cystic teratoma (n = 40, teratoma group). Serum anti-Müllerian hormone (AMH) levels were measured preoperatively and 1 month after surgery.

Results

The rate of decrease in serum AMH levels after laparoscopic cystectomy was significantly higher in the endometrioma group than in the teratoma group (0.35 ± 0.04% vs. 0.19 ± 0.04%, p = 0.013). In patients with mature cystic teratoma, a statistically significant correlation between the rate of decrease in serum AMH levels and cyst size was observed (r = 0.391, p = 0.013); the rate of decrease in serum AMH levels after surgery was significantly higher in the > 5.13 cm subgroup than in the ≤ 5.13 cm subgroup (p = 0.006).

Conclusions

Laparoscopic cystectomy for endometriomas may result in a more significant damage to the ovarian reserve compared with that for ovarian mature cystic teratomas. Cyst diameter and reduced ovarian reserve after surgery were not correlated in patients with endometriomas, whereas a significant correlation was observed in patients with ovarian mature teratomas. The decrease in AMH levels was more evident in patients with a mature teratoma > 5.13 cm.

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endometrioma

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