The Impact of Enucleation of Unilateral Endometriomas on the Ovarian Reserve and Reproductive Function

Grigalashvili Nugesha
In: Journal of Medical - Clinical Research & Reviews · 2022 · vol. 6(5) · doi:10.33425/2639-944x.1275 · W4292417046
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This study found that while laparoscopic endometrioma removal initially decreased ovarian reserve, it recovered in younger women within six months, with age and preoperative reserve being key factors for reproductive outcomes, not cyst size.

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Abstract

Background: The data concerning the impact of endometrial cystectomy on the ovarian reserve is controversial. It is not clear how the cyst size and women age influence the outcome of surgical intervention in participants with ovarian endometrioma. Objectives: The study was aimed to evaluate the impact of enucleation of unilateral endometriomas on the ovarian reserve and reproductive function with regard to cyst size and women age. Materials and Methods: The study included 60 participants aged 19-40 years, with unilateral endometrioma and infertility, who underwent laparoscopy. Study participants were divided into 2 groups by the size of cyst: <3 and ≥ 3 cm. Each group was divided into subgroups by the age of participants: <35 and ≥ 35 years. The serum level of anti-mullerian hormone and antral follicle count were determined before, after 1 and 6 months of cystectomy. The rate of pregnancy was recorded during 1 year of post-surgery. Results: The level of anti-mullerian hormone and antral follicle count were significantly low in participants aged ≥ 35. Ovarian reserve decreased in all participants after 1 month of surgery, restored after 6 months in younger women, but didn’t reach the preoperative level. The pregnancy rate was low in participants aged ≥ 35 with cyst ≥ 3cm and no significant difference was found between smaller vs. larger cyst groups. Conclusion: Endometrial cyst size does not affect the reproductive outcome in women after laparoscopic cystectomy; however, the age of participants and preoperative ovarian reserve are significant factors regarding reproductive function. Thus, preoperative ovarian reserve should be considered before surgery, especially in women aged ≥35 years.

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endometriomainfertility

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