Introduction
Most often with endometriosis, the so-called chronic pain syndrome
in the pelvic region is noted. For the early diagnosis of endometriosis,
along with the analysis of clinical data, using ultrasound, endoscopic
and magnetic resonance studies, a method for identifying tumor
antigens is very promising. 1‒3 Therefore, the tumor antigen CA-125
is currently the method of choice in the diagnosis of endometriosis.
Diagnosis of endometriosis using this test without a full range of
laboratory and instrumental studies is not legitimate. The aim of the
work was to study in women with endometriotic ovarian cysts the
Method
of early non-invasive diagnosis through tumor markers CA-
125 and the assessment of the ovarian reserve after treatment with
antimuller hormone.
Material and methods
Under our supervision, there were 47 women of reproductive
age with signs of endometriotic ovarian cysts diagnosed within 1-2
months after visiting a gynecologist. Each patient underwent an
analysis of development factors in comparison with healthy ones. For
a comprehensive clinical and laboratory diagnosis of endometriotic
ovarian cysts, ultrasound, quantitative analyzes for tumor markers
CA-125 and for antimuller hormone were used. At the same time, the
study in the blood of SA-125 tumor markers was carried out in the
follicular phase and on the days of menstruation for early diagnosis of
ovarian endometriosis with subsequent verification by ultrasound, and
the determination of the anti-Mühller hormone to assess the ovular
reserve was performed before and after surgical treatment on the
ovary.
Research results
The age of women ranged from 21 to 27 years. In a prospective
study, we managed in 41 women with endometriotic ovarian cysts
to diagnose twice the oncomarkers of CA-125 (in the 1st phase and
during menstruation), and twice the measurement of the antimuller
hormone before and after surgical treatment. The ratio of indicators
of the level of CA-125 during menstruation to the indicator during
the follicular phase of the cycle exceeded 1.5 times the average
normal values, which indicated the presence of endometriosis during
ultrasound verification (Figure 1). It should be noted that among 41
patients in 9 (22.4%) patients, the endometriotic cyst was not verified
by ultrasound due to the small shape (diameter less than 2.5-3cm). In
outpatient practice, a gynecologist faces a difficult question regarding
the routing and management tactics of such patients, especially
if there is an acute issue of pregnancy. The surgical approach for
endometriotic ovarian cysts is generally consistent with that for any
benign ovarian tumor. In the treatment of our patients of reproductive
age, the most important was the preservation of fertility. At the same
time, all the principles of microsurgical surgery were not always
observed in all hospitals using the gentle effects of modern surgical
energies on the ovarian tissue (enucleation of only the affected areas)
to maximize the preservation of the ovarian reserve.
Figure 1 Diagnostic comparative increase in patients with ovarian
endometriosis of the tumor marker CA-125.
The scope of the operation must have been designed to reduce the
risk of relapse. Our research data showed a significant decrease in
serum concentration of AMH (anti-Müller hormone) after surgical
removal of the endometrioma compared to average values (Figure 2).
It was shown that surgical treatment of ovarian endometrioma
is accompanied by a decrease in serum AMH level by 2.36 times.
Thus, the results of the study indicate the negative impact of surgical
removal of ovarian endometrioma on ovarian reserve in women of
reproductive age. In our study, an AMG study was conducted in 47
patients after surgical treatment, in which a low mean level of 2.1+-
1.5ng\l was determined.
J Pediatr Neonatal Care. 2019;9(6):165‒166. 165
©2019 Askerov et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and build upon your work non-commercially.
Non-invasive research in ovarian endometriosis
Volume 9 Issue 6 - 2019
Askerov AA,1 Satybaldieva AJ2
1Department of Obstetrics and Gynecology of KRSU,
Kyrgyzstan
2Department of Obstetrics and Gynecology KSMA, Kyrgyzstan
Correspondence: Askerov AA, professor of the Department
of Obstetrics and Gynecology of KRSU, 0550331731,
Email
Received: November 13, 2019 | Published: December 03,
2019
Abstract
The article presents the results of a study on noninvasive early diagnosis of the
endometriosis ovarian cyst via ultrasound and on-markers CA-125. The effectiveness of
using antimulyler hormone in predicting the reserve capacity of the ovary after surgical
treatment of endometriosis cyst.
Keywords
endometriosis, cyst, ovary, oncomarkers, hormone, surgical treatment
Journal of Pediatrics and Neonatal Care
Mini Review
Open Access
Non-invasive research in ovarian endometriosis
166
Copyright:
©2019 Askerov et al.
Citation: Askerov AA, Satybaldieva AJ. Non-invasive research in ovarian endometriosis. J Pediatr Neonatal Care. 2019;9(6):165‒166.
DOI: 10.15406/jpnc.2019.09.00400
Figure 2 Dynamics of AMH level in patients with ovarian endometriosis before and after surgical treatment.
Acknowledgments
None.
Conflicts of interest
The authors declared there is no conflict of interest.
Funding
None.
References
1. Matveeva NV . The effect of endosurgical coagulating effects on ovarian
reserve. Doktor Ru. 2013;1(79):18‒20.
2. Tikhomirov AL. Endometriosis - modern possibilities of
pharmacotherapy. Russian Medical Journal. 2013;21(23):1134‒1136.
3. Burney RO. The genetics and biochemistry of endometriosis. Curr Opin
Obstet Gynecol. 2013;25(4):280‒286.
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