Ovarian Reservation in Women with Ovarian Endometriosis Cyst after Laparoscopic Cystectomy and Leuprorelin Acetate Administration

Reza F. Akhmad, Yuli Trisetiyono, I Edward K. Setiawan, Besari Adi Pramono, Soerjo Hadijono, Inu Mulyantoro, Ediwibowo Ambari
In: Indonesian Journal of Obstetrics and Gynecology · 2023 · pp. 87–92 · doi:10.32771/inajog.v11i2.1815 · W4380264916
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Laparoscopic cystectomy significantly reduced ovarian reserve (AMH) in women with ovarian endometriosis cysts, while leuprorelin acetate administration showed no further significant impact.

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Abstract

Objective: To determine differences in ovarian reserve in women with ovarian endometrial cysts after laparoscopic cystectomy and leuprorelin acetate administrationMethods: Single cohort prospective pre and post-test design study with 25 research subjects. The independent variables were interventional laparoscopic cystectomy, and leuprorelin acetate administration. The dependent variable is ovarian reserve as measured by AMH levels.Results: The research subjects had a mean age of 31 years and a BMI of 23.55 kg/m2. There were 8 subjects with unilateral cysts and 17 subjects with bilateral cysts. Preoperative AMH levels had a median value of 1.32 ng/mL (0.88-5.13), postoperative AMH levels had a median value of 1.07 ng/mL (0.60-4.53), and postoperative AMH levels + Leuprorelin Acetate injection had a median value of 1.06 ng/mL (0.50-4.65). There was a significant difference between preoperative AMH and postoperative AMH (p<0.001). There was no significant difference between postoperative AMH and postoperative AMH + Leuprorelin Acetate injection (p=0.149). BMI has a relationship (p=0.048) with pre-operative AMH levels with a weak and opposite relationship (r= -0.399).Conclusion: There was a statistically significant 18.9% decrease between pre-operative post-operative AMH levels. Body Mass Index (BMI) and pre-operative AMH levels are associated with one another.Keywords: anti-müllerian hormone, leuprorelin acetate, ovarian cystectomy, ovarian reserve.AbstrakTujuan: Mengetahui perbedaan cadangan ovarium pada perempuan dengan kista endometrium ovarium setelah laparoskopi kistektomi dan injeksi leuprorelin asetat.Metode: Desain penelitian pre dan post-test prospektif kohort tunggal dengan 25 subjek penelitian. Variabel bebas adalah intervensi laparoskopi kistektomi, dan injeksi leuprorelin asetat. Variabel terikat adalah cadangan ovarium yang diukur dengan kadar AMH.Hasil: Subjek penelitian memiliki rerata usia 31 tahun dan IMT 23,55 kg/m2. Terdapat 8 subjek dengan kista unilateral, 17 subjek dengan kista bilateral. Kadar AMH praoperasi memiliki nilai median 1,32 ng/mL (0,88-5,13), kadar AMH pascaoperasi memiliki nilai median 1,07 ng/mL (0,60-4,53), dan kadar AMH pascaoperasi + injeksi Leuprorelin Asetat memiliki nilai median 1,06 ng/mL (0,50-4,65). Ada perbedaan yang signifikan antara AMH pra operasi dan AMH pascaoperasi (p<0,001). Tidak ada perbedaan bermakna antara AMH pascaoperasi dengan injeksi AMH + Leuprorelin Asetat pascaoperasi (p=0,149). IMT memiliki hubungan (p=0,048) dengan kadar AMH pra operasi dengan hubungan yang lemah dan berlawanan (r= -0,399).Kesimpulan: Terdapat penurunan 18,9% antara tingkat AMH pra-operasi dan tingkat AMH pasca-operasi yang signifikan secara statistik. Ada hubungan antara BMI dan tingkat AMH pra-operasiKata kunci: cadangan ovarium, hormon anti-müllerian, kistektomi ovarium, leuprorelin asetat.
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Objective

To determine differences in ovarian reserve in women with ovarian endometrial cysts after laparoscopic cystectomy and leuprorelin acetate administration

Methods

Single cohort prospective pre and post-test design study with 25 research subjects. The independent variables were interventional laparoscopic cystectomy, and leuprorelin acetate administration. The dependent variable is ovarian reserve as measured by AMH levels.

Results

The research subjects had a mean age of 31 years and a BMI of 23.55 kg/m2. There were 8 subjects with unilateral cysts and 17 subjects with bilateral cysts. Preoperative AMH levels had a median value of 1.32 ng/mL (0.88-5.13), postoperative AMH levels had a median value of 1.07 ng/mL (0.60-4.53), and postoperative AMH levels + Leuprorelin Acetate injection had a median value of 1.06 ng/mL (0.50-4.65). There was a significant difference between preoperative AMH and postoperative AMH (p<0.001). There was no significant difference between postoperative AMH and postoperative AMH + Leuprorelin Acetate injection (p=0.149). BMI has a relationship (p=0.048) with pre-operative AMH levels with a weak and opposite relationship (r= -0.399).

Conclusion

There was a statistically significant 18.9% decrease between pre-operative post-operative AMH levels. Body Mass Index (BMI) and pre-operative AMH levels are associated with one another.

Keywords

anti-müllerian hormone, leuprorelin acetate, ovarian cystectomy, ovarian reserve. Abstrak Tujuan: Mengetahui perbedaan cadangan ovarium pada perempuan dengan kista endometrium ovarium setelah laparoskopi kistektomi dan injeksi leuprorelin asetat. Metode: Desain penelitian pre dan post-test prospektif kohort tunggal dengan 25 subjek penelitian. Variabel bebas adalah intervensi laparoskopi kistektomi, dan injeksi leuprorelin asetat. Variabel terikat adalah cadangan ovarium yang diukur dengan kadar AMH. Hasil: Subjek penelitian memiliki rerata usia 31 tahun dan IMT 23,55 kg/m2. Terdapat 8 subjek dengan kista unilateral, 17 subjek dengan kista bilateral. Kadar AMH praoperasi memiliki nilai median 1,32 ng/mL (0,88-5,13), kadar AMH pascaoperasi memiliki nilai median 1,07 ng/mL (0,60-4,53), dan kadar AMH pascaoperasi + injeksi Leuprorelin Asetat memiliki nilai median 1,06 ng/mL (0,50-4,65). Ada perbedaan yang signifikan antara AMH pra operasi dan AMH pascaoperasi (p<0,001). Tidak ada perbedaan bermakna antara AMH pascaoperasi dengan injeksi AMH + Leuprorelin Asetat pascaoperasi (p=0,149). IMT memiliki hubungan (p=0,048) dengan kadar AMH pra operasi dengan hubungan yang lemah dan berlawanan (r= -0,399). Kesimpulan: Terdapat penurunan 18,9% antara tingkat AMH pra-operasi dan tingkat AMH pasca-operasi yang signifikan secara statistik. Ada hubungan antara BMI dan tingkat AMH pra-operasi Kata kunci: cadangan ovarium, hormon anti-müllerian, kistektomi ovarium, leuprorelin asetat.

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