Ovarian reserve after three-step laparoscopic surgery for endometriomas utilizing dienogest: a non-randomized prospective pilot study

Michio Kitajima, Kanako Matsumoto, Naoko Murakami, Ayumi Harada, Yuriko Kitajima, Hideaki Masuzaki, Kiyonori Miura
2020 · doi:10.21203/rs.3.rs-21576/v1 · W3115249050
preprint OA: green CC0
📄 Open PDF View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study compared ovarian reserve after three-step laparoscopic surgery with dienogest versus conventional one-step surgery, finding dienogest aided AMH recovery and reduced peritoneal inflammation.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This non-randomized prospective pilot study evaluated whether a three-step laparoscopic strategy for endometriomas that used first-look laparoscopy with fenestration and drainage, followed by 3 months of oral dienogest and then second-look laparoscopy with cystectomy, would affect ovarian reserve. Twelve women who chose three-step surgery with dienogest were compared to twelve women who had conventional one-step surgery without peri-surgical medications, with ovarian reserve assessed using serum AMH measured at baseline, 3–6 months post-surgery, and 9–12 months post-surgery, and with peritoneal fluid cytokines/chemokines measured in the three-step group. AMH decreased after dienogest and after surgery in both groups, but AMH recovery at 9–12 months was more evident in the three-step group, while peritoneal inflammatory cytokines and chemokines (including IL-1β, IL-6, IL-8, TNF-α, and MCP-1) were downregulated at second look compared with first look; the study also notes limitations including small sample size and non-random allocation with baseline differences in infertility status. This paper is centrally about endometriosis—specifically, ovarian reserve after three-step laparoscopic surgery for endometriomas using dienogest.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Abstract Background Surgery for endometriomas may cause detrimental effects on ovarian reserve. In this study, we evaluated the efficacy of three-step laparoscopic surgery for endometriomas utilizing novel progestin, dienogest in terms of post -surgical ovarian reserve. Methods Twelve women received first look laparoscopy (FLL) with fenestration and drainage. Immediately after the surgery, they took oral dienogest 2mg for three months, then they received second look laparoscopy (SLL) with cystectomy. We compared the effects on ovarian reserve by serum AMH levels between women had three step management with dienogst and another twelve women had conventional one-step surgery without medications. In women had three-step surgery with dienogest, the changes in concentration of proinflammatory cytokines and chemokines (interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1) in peritoneal fluids were evaluated. Results Serum AMH levels were significantly decreased after three months of dienogest following FLL. AMH levels were also significantly decreased 3-6 month both after SLL and after one-step surgery, however, recovery of serum AMH levels at 9-12 months after surgery were evident in women had three-step surgery comparing to those of women had one-step surgery. Proinflammatory cytokines and chemokines in peritoneal fluids were down regulated at the time of SLL comparing to those of FLL. Conclusions Three-step surgery with dienogest may be a beneficial approach to protect ovarian reserve. Dienogest may exert its effects in part by lowering proinflammatory cytokines and chemokines.

My notes (saved in your browser only)

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 (20)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK