Impact of Surgical Management of Endometrioma on Ovarian Reserve

Mosammat Rashida Begum, Nazia Ehsan, Mariya Ehsan, Nahid Parveen, Nasreen Farhana, Nasrin Farhana, Azaz Bin Sharif
In: Bangladesh Journal of Obstetrics & Gynaecology · 2022 · vol. 35(2) , pp. 96–101 · doi:10.3329/bjog.v35i2.58793 · W4221005892
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

Surgical excision of ovarian endometriomas significantly reduces ovarian reserve, evidenced by a marked decline in AMH levels three and six months post-surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This prospective observational study evaluated how surgical excision of ovarian endometriomas affects ovarian reserve in 155 subfertile patients (endometrioma ≥3 cm) by measuring FSH, estradiol (E2), and anti-Müllerian hormone (AMH) before surgery and again at 3 and 6 months. After excluding factors that could confound ovarian function (e.g., prior cystectomy, one-ovary removal, irregular cycles, endocrine disorders, low baseline AMH, and recent endometriosis medications), the authors found a marked decline in AMH from baseline at both 3 and 6 months after surgery (p<0.0001), while FSH and AMH did not differ significantly between 3 and 6 months. The main limitation is that ovarian reserve was assessed using repeated hormone measures without a broader functional fertility outcome, and the cohort is limited to patients selected for surgery due to subfertility. This paper is centrally about endometriosis—specifically the impact of endometrioma cystectomy on ovarian reserve measured by AMH.

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Abstract

Objective: The aim of this study was to explore the outcome of surgical removal of endometriotic cyst on ovarian reserve. Materials and methods: This prospective observational study was carried out in Infertility Care and Research Centre, Dhaka, Bangladesh between January 2011 and December 2018. One hundred and fifty-five patients, who had an ultrasonographic diagnosis of endometrioma measuring ³3 cm and underwent surgical excision due to subfertility were the candidates for this study. The exclusion criteria were a) previous ovarian cystectomy, b) removal of one ovary, c) irregular menstrual cycle, d) polycystic ovarian syndrome e) endocrine disorder, f) low AMH (<1ng/ml), g) history of taking medication for endometriosis that could affect ovarian function, e.g., GnRH analogues or oral contraceptives during the 6 months preceding scheduled surgery. To investigate the effect of surgery on ovarian reserve, their FSH, E2 and AMH were measured before and after surgery. Tests were done before surgery and repeated after 3 months and 6 months of surgery. A value of < 0.05 was considered significant. Results: Mean age of the patients was 31.72 ±2.77 years. The baseline FSH, E2 and AMH were within normal limit. In 63.88% of the cases the cysts were unilateral and 83.22% of the cases the size of the cysts were within 10 cm. To assess the change of ovarian reserve FSH, E2 and AMH were measured in 3 and 6 months after surgery. There was marked declining of AMH level from baseline to both 3 months and 6 months after surgery p is <0.0001. There was no significant change of FSH and AMH between 3 months and 6 months after surgery. Conclusion: Cystectomy in ovarian endometrioma significantly reduces ovarian reserve, which is menifested by reduced level of AMH. Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 96-101
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Objective

The aim of this study was to explore the outcome of surgical removal of endometriotic cyst on ovarian reserve.

Materials and methods

This prospective observational study was carried out in Infertility Care and Research Centre, Dhaka, Bangladesh between January 2011 and December 2018. One hundred and fifty-five patients, who had an ultrasonographic diagnosis of endometrioma measuring ³3 cm and underwent surgical excision due to subfertility were the candidates for this study. The exclusion criteria were a) previous ovarian cystectomy, b) removal of one ovary, c) irregular menstrual cycle, d) polycystic ovarian syndrome e) endocrine disorder, f) low AMH (<1ng/ml), g) history of taking medication for endometriosis that could affect ovarian function, e.g., GnRH analogues or oral contraceptives during the 6 months preceding scheduled surgery. To investigate the effect of surgery on ovarian reserve, their FSH, E2 and AMH were measured before and after surgery. Tests were done before surgery and repeated after 3 months and 6 months of surgery. A value of < 0.05 was considered significant.

Results

Mean age of the patients was 31.72 ±2.77 years. The baseline FSH, E2 and AMH were within normal limit. In 63.88% of the cases the cysts were unilateral and 83.22% of the cases the size of the cysts were within 10 cm. To assess the change of ovarian reserve FSH, E2 and AMH were measured in 3 and 6 months after surgery. There was marked declining of AMH level from baseline to both 3 months and 6 months after surgery p is <0.0001. There was no significant change of FSH and AMH between 3 months and 6 months after surgery.

Conclusion

Cystectomy in ovarian endometrioma significantly reduces ovarian reserve, which is menifested by reduced level of AMH. Bangladesh J Obstet Gynaecol, 2020; Vol. 35(2): 96-101 Downloads 215 290

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endometriosisendometriomainfertility

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