Ovarian reserve in women with endometriosis under total cystectomy compared to partial cystectomy: A randomized clinical trial

Atiye Javaheri, Samane Kabirpour Ashkezar, Maryam Eftekhar, Seiede Zahra Ghanadzade Tafti
International journal of reproductive biomedicine · 2021 · vol. 19(7) , pp. 619–624 · doi:10.18502/ijrm.v19i7.9472 · PMID:34458670 · PMC8387706 · W3195656519
article OA: gold CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Total cystectomy significantly reduced anti-Müllerian hormone levels more than partial cystectomy in women with endometriosis three months after surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This randomized clinical trial evaluated ovarian reserve outcomes in women with endometriosis undergoing cystectomy, comparing total cystectomy versus partial cystectomy, using high-level measures of ovarian reserve to assess differences between surgical approaches. The key finding was that ovarian reserve differed between the two groups following surgery, with results supporting one approach over the other in preserving ovarian function, though the specific magnitude of change is constrained by the trial’s sample size and design as reported in the paper. A major caveat is that the analysis depends on the measured ovarian reserve endpoints and the follow-up period available in the study. This paper is centrally about endometriosis — specifically, it compares ovarian reserve after total versus partial cystectomy in women with endometriosis.

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Abstract

BACKGROUND: The standard procedure for ovarian endometriosis is laparoscopic excision of ovarian cysts and complete removal of the cyst capsule using the striping technique. Owing to the possibility of reducing ovarian reserve, and in some cases, the premature ovarian failure, the safety remains to be known. OBJECTIVE: To compare the ovarian reserve in women with endometriosis who underwent total cystectomy with partial cystectomy. MATERIALS AND METHODS: In this randomized clinical trial, 56 women with endometriosis who were referred to the Research and Clinical Center for Infertility and Shahid Sadoughi Hospital, Yazd, Iran between January and February 2020 were randomly assigned into two groups (n = 25/each); group I (total cystectomy) and group II (partial cystectomy). To assess the ovarian reserves, the anti-Müllerian hormone (AMH) level before and three months after surgery was measured and compared between the two groups. RESULTS: No significant difference was observed in the AMH levels before and after surgery (p = 0.52, p = 0.32, respectively). However, the mean reduction of AMH in total cystectomy group was significantly higher than the partial cystectomy (p = 0.001). CONCLUSION: Cystectomy in women with endometriosis reduces ovarian reserve and can help maintain some ovarian reserve by performing partial instead of total cystectomy.

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Condition tags

endometriosisinfertility

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