OC08: Ovarian damage after laparoscopic excision of endometriomas: a quantitative analysis by 3D ultrasound

To compare three-dimensional (3D) ultrasound markers of ovarian reserve between the operated and the contralateral ovary after laparoscopic stripping of endometriomas. Thirteen patients who underwent laparoscopic excision of monolateral endometriotic cysts more than 3 months previously were prospectively recruited. Patients with irregular cycles, polycystic ovaries, previous ovarian surgery, bilateral cysts, deep infiltrating endometriosis or recent hormonal therapy were excluded. Patients underwent transvaginal 3D power Doppler ultrasound in the early follicular phase (day 2–4) and the 3D volumes of the ovaries were stored for later analysis with VOCAL software (Virtual Organ Computer-aided AnaLysis). For each patient we compared the ovarian volume, antral follicle count (AFC) and 3D power Doppler VFI (vascularization flow index, defined as percentage of color voxels in the selected volume × mean signal intensity of power Doppler) in the operated and in the intact contralateral ovary. The sonographer was blinded for the operated side. Median age was 33 (IR, 31–34) years. Median diameter of endometrioma was 41 (IR, 30–50) mm. Mean ( ± SD) time elapsed after laparoscopy was 18 ± 7 months. The table shows 3D ultrasound markers in the operated and the contralateral ovary. Acquisition of 3D volumes represents a valid tool for the study of ovarian reserve. As expected, we observed reduced volumes in the operated ovaries. However, the number of antral follicles and blood flow indices were similar. The potential effects of laparoscopic stripping of endometriomas on fertility must be taken into consideration. Larger number of cases are needed to assess new 3D standards for volume and antral follicles.