Ovarian reserve in patients who have undergone endometriosis surgery
Laparoscopic cystectomy and cystotomy for endometriosis both reduced ovarian reserve, with cystectomy causing more damage and incision with coagulation increasing recurrence risk.
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This prospective study evaluated ovarian reserve and reproductive outcomes in 150 women, including 100 patients undergoing laparoscopy for endometriomas and a control group of women operated for tubal-factor infertility. Among the endometrioma patients, ovarian function was compared between laparoscopic cystotomy (incision and thermal coagulation) and laparoscopic cystectomy, measuring ovarian volume, antral follicle count, preovulatory follicle presence, AMH, FSH, Ca 125, inhibin B, and pregnancy rates one year after surgery. Ovarian volume, antral follicle count, and FSH were significantly worse in the endometriosis surgery group than in controls, and within the study group there were no significant differences between cystectomy and cystotomy in ovarian volume, antral follicle count, AMH, or inhibin B. The paper concludes that both techniques diminished ovarian reserve, with cystectomy described as more aggressive for ovarian tissue damage, and cystotomy associated with a higher recurrence risk. This paper is centrally about endometriosis — it compares laparoscopic cystotomy versus cystectomy for ovarian endometriomas and assesses resulting ovarian reserve.
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