One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts

Marta Kostrzewa, Jacek R Wilczyński, Ewa Głowacka, Monika Żyła, Krzysztof Szyłło, Grzegorz Stachowiak
International Journal of Gynecology & Obstetrics · 2019 · vol. 146(3) , pp. 350–356 · doi:10.1002/ijgo.12884 · PMID:31197834 · W2949630087
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Laparoscopic cystectomy for endometriomas significantly decreased anti-Müllerian hormone levels by 3 months, with no further decline at 12 months, while antral follicle count and ovarian volume remained stable.

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Abstract

OBJECTIVE: To determine the long-term impact of laparoscopic cystectomy for endometriomas and benign cysts on ovarian reserve and selection of the most effective method of assessment. METHODS: The present study was carried out between November 2013 and December 2016. Participants were assigned to laparoscopic cystectomy for diagnosed unilateral benign ovarian cysts and divided into groups: the endometrioma group (EG) (n=35) and the other benign ovarian tumor group (OG) (n=35). Before and at 3 and 12 months after the procedure, transvaginal ultrasonography was performed to assess antral follicle count (AFC) and ovarian volume (OvVol); laboratory tests were ordered for anti-Műllerian hormone (AMH) serum concentration assays. Pregnancy rates were counted in a 12-month follow-up. Statistica12 software was used for analysis. RESULTS: The present study included 70 women aged 18-40 years. AMH serum concentration decreased significantly 3 months after laparoscopic cystectomy (4.89 ± 3.66 ng/mL to 3.45 ± 3.37 ng/mL; P<0.001). A greater decrease of AMH concentrations was observed in the EG (45.39% vs 14.87%; P=0.021). Twelve months of observation revealed a suppression in the drop of the AMH concentration, while AFC and OvVol remained unaffected. The likelihood of spontaneous pregnancy was three times higher in the OG (hazard ratio [HR] 3.57, 95% confidence interval [CI] 1.08-12.5). CONCLUSION: There was a significant decline in AMH levels in the EG 3 months after cystectomy. No further fall in AMH concentration was observed in the 12-month follow-up. The serum AMH concentration could be considered a valuable marker for ovarian reserve assessment after laparoscopic cystectomy.

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Condition tags

mesh:D004715endometrioma

MeSH descriptors

Anti-Mullerian Hormone Endometriosis Laparoscopy Ovarian Cysts Ovarian Reserve Adolescent Adult Anti-Mullerian Hormone Biomarkers Biomarkers Endometriosis Female Follow-Up Studies Humans Laparoscopy Ovarian Cysts Ovarian Follicle Ovarian Follicle Pregnancy Pregnancy Rate

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (25)

Cited by (28)

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