Small-size ovarian endometriosis. The state of ovarian reserve before and after organ-sparing surgery

A.A. Solomatina, E.А. Sadovnikova, M.Yu. Tyumentseva, M.Z. Argun, L.B. Chabieva, S. V. Shtyrov, O.V. Bratchikova
In: Voprosy ginekologii, akušerstva i perinatologii · 2019 · vol. 18(1) , pp. 20–27 · doi:10.20953/1726-1678-2019-1-20-27 · W2940182662
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This study found that ovarian reserve parameters like ovarian tissue volume, antral follicle count, and AMH levels decreased less after puncture-ablation surgery compared to excision surgery for ovarian endometriosis.

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This paper studied ovarian reserve characteristics in 73 patients with small-size ovarian endometriosis treated surgically, comparing excision by stripping (n=39) versus puncture-ablation (n=34). Ovarian reserve was assessed using ovarian tissue volume, antral follicle number, and serum anti-Müllerian hormone (AMH) measured preoperatively and again at 3, 6, and 12 months postoperatively. The authors found that after puncture-ablation, ovarian tissue volume and antral follicle number were higher than after excision (volume 1.2-fold higher and antral follicles 1.8-fold higher), and AMH levels were higher as well (2.8 ± 0.4 vs 1.4 ± 0.2 ng/ml). This paper is centrally about endometriosis — specifically small-size ovarian endometriosis and how different organ-sparing surgical techniques affect ovarian reserve before and after surgery.

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Gynecology, Obstetrics and Perinatology - Gynecology, Obstetrics and Perinatology - 2019 volume 18 issue 1 Small-size ovarian endometriosis. The state of ovarian reserve before and after organ-sparing surgery Authors / Institutions Antonina A. Solomatina / E.A.Sadovnikova / Marina Yu. Tyumentseva / M.Z.Argun / Leila B. Chabieva / S.V.Shtyrov / Olga V. Bratchikova / The objective. Тo study parameters of ovarian reserve in patients with EOT before and after various methods of surgical treatment. Patients and methods. We examined 73 patients after surgical treatment of ovarian endometriosis: 39 after excision by stripping, 34 – after puncture-ablation. Assessment of ovarian reserve was based on calculation of the volume of ovarian tissue (V, cm3), number of antral follicles (NAF), anti-Müllerian hormone (AMH) testing in the pre- and post-operative period (after 3, 6, 12 mos.). Results. Comparison of two groups of patients showed that after puncture-ablation V is by 1.2 times higher than in the group of patients after excision of endometriomas, and NAF is by 1.8 times higher. Serum ANH concentrations were 2.8 ± 0.4 and 1.4 ± 0.2 ng/ml after puncture-ablation and excision, respectively. Conclusion. Assessment of ovarian reserve is suggestive of its more significant decrease after excision as compared with the puncture-ablation technique. The ablation method is preferable in patients with small-size ovarian endometriosis and in infertile patients. Key words: anti-Müllerian hormone, ovarian reserve, punction-ablation technique, excision, small endometrioid ovarian tumours. For citation: Solomatina A.A., Sadovnikova E.А., Tyumentseva M.Yu., Argun M.Z., Chabieva L.B., Shtyrov S.V., Bratchikova O.V. Small-size ovarian endometriosis. The state of ovarian reserve before and after organ-sparing surgery. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(1): 20–27. (In Russian). DOI: 10.20953/1726-1678-2019-1-20-27 Patients and methods. We examined 73 patients after surgical treatment of ovarian endometriosis: 39 after excision by stripping, 34 – after puncture-ablation. Assessment of ovarian reserve was based on calculation of the volume of ovarian tissue (V, cm3), number of antral follicles (NAF), anti-Müllerian hormone (AMH) testing in the pre- and post-operative period (after 3, 6, 12 mos.). Results. Comparison of two groups of patients showed that after puncture-ablation V is by 1.2 times higher than in the group of patients after excision of endometriomas, and NAF is by 1.8 times higher. Serum ANH concentrations were 2.8 ± 0.4 and 1.4 ± 0.2 ng/ml after puncture-ablation and excision, respectively. Conclusion. Assessment of ovarian reserve is suggestive of its more significant decrease after excision as compared with the puncture-ablation technique. The ablation method is preferable in patients with small-size ovarian endometriosis and in infertile patients. Key words: anti-Müllerian hormone, ovarian reserve, punction-ablation technique, excision, small endometrioid ovarian tumours. For citation: Solomatina A.A., Sadovnikova E.А., Tyumentseva M.Yu., Argun M.Z., Chabieva L.B., Shtyrov S.V., Bratchikova O.V. Small-size ovarian endometriosis. The state of ovarian reserve before and after organ-sparing surgery. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(1): 20–27. (In Russian). DOI: 10.20953/1726-1678-2019-1-20-27

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