Faculty Opinions recommendation of The effect of laparoscopic excisional and ablative surgery on ovarian reserve in patients with endometriomas: A retrospective study.

ABSTRACT: This study investigates the effect of 2 laparoscopic methods on ovarian reserve in patients of reproductive age with endometriomas.This was a retrospective study performed at a tertiary medical center from Jan 1st to Dec 31st, 2016. Laparoscopic cystectomy (group 1, 46 patients) and laparoscopic ovarian drainage and ablation with bipolar coagulation at low power (group 2, 30 patients) were performed to treat endometriomas larger than 3 cm. Anti-Müllerian hormone was used to assess ovarian reserve before and after surgery.There were no statistically significant differences in patients' baseline clinical characteristics, endometriotic stage, operative time, and follow-up time between the groups. The mean serum anti-Müllerian hormone concentration decreased significantly from 4.25 ng/ml to 3.40 ng/ml in group 1 compared with 4.47 ng/ml to 3.95 ng/ml in group 2 (P = .04). Pregnancy rates were 71.05% in group 1 and 73.08% in group 2, with a mean follow-up of 30.40 months and 32.35 months (P > .99), respectively. Although there was no statistical significance, the recurrence rate in group 1 was lower than that in group 2 (4.35% vs 16.67%, respectively; P = .11). The mean diameter of recurrent cysts was 1.75 cm in group 1 and 1.54 cm in group 2 (P = .13).Appropriate laparoscopic electrocautery of the endometrioma wall with a bipolar instrument may be a valid alternative to traditional laparoscopic cystectomy, with less effects on ovarian reserve.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. PMID: 33607770 Funding information This work was supported by: Medical Science and Technology Project Foundation of Zhejiang Province, Grant ID: 2018KY486 Medical Science and Technology Project Foundation of Zhejiang Province, Grant ID: 2018KY109 Medical Science and Technology Project Foundation of Zhejiang Province, Grant ID: 2018KY465 Zhejiang Provincial Natural Science Foundation of China, Grant ID: LQ19H040014 National Natural Science Foundation of China, Grant ID: 81871135 National Natural Science Foundation of China, Grant ID: 81671435 More Less keyboard_arrow_down