The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometrioma

Mehdizadeh Kashi A, Abolfazl Mehdizadeh Kashi, Shahla Chaichian, Shideh Ariana, Ariana S, Fazaeli M, Masoumeh Fazaeli, Yousef Moradi, Mandana Rashidi, Rashidi M, Zahra Najmi, Najmi Z
International Journal of Gynecology & Obstetrics · 2016 · vol. 136(2) , pp. 200–204 · doi:10.1002/ijgo.12046 · PMID:28099732 · W3143049899
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Laparoscopic cystectomy reduced serum AMH levels, indicating decreased ovarian reserve, with greater reductions observed in patients with bilateral endometriomas or unilateral endometriomas measuring at least 50 mm.

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Abstract

OBJECTIVE: To evaluate the effects of laparoscopic cystectomy on serum anti-Müllerian hormone (AMH) level as a marker of ovarian reserve in patients with endometrioma. METHODS: A prospective observational study enrolled patients aged younger than 40 years who were referred to a tertiary center in Tehran, Iran, between January 1, 2013 and December 31, 2014 to undergo laparoscopic cystectomy for ovarian endometriomas at least 30 mm in diameter, or regardless of size for patients with infertility, dysmenorrhea, dyspareunia, or dyschezia. Baseline and 6-month post-operative AMH levels were compared. RESULTS: Data from 70 patients were included in the analyses. Among patients with unilateral endometriomas, lower pre-operative AMH levels were observed in patients with endometriomas at least 50 mm in diameter (P=0.027), whereas cyst size was not associated with differences in pre-operative AMH level in patients with bilateral endometriomas (P=0.227). Across the entire study population, post-operative AMH levels were lower than the baseline (P=0.008). Greater post-operative decreases in AMH were associated with bilateral cysts compared with unilateral cysts (P=0.046), cysts being at least 50 mm in diameter among patients with unilateral cysts (P=0.028), and both cysts being at least 50 mm in diameter among patients with bilateral cysts (P=0.025). CONCLUSION: Laparoscopic cystectomy was associated with post-operative decreases in serum AMH, particularly with bilateral involvement and endometriomas at least 50 mm in diameter.

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Condition tags

endometriosisendometriomadysmenorrheadyspareuniainfertility

MeSH descriptors

Anti-Mullerian Hormone Cystectomy Endometriosis Laparoscopy Ovarian Cysts Ovarian Reserve Adult Anti-Mullerian Hormone Biomarkers Biomarkers Cystectomy Endometriosis Female Humans Iran Laparoscopy Ovarian Cysts Postoperative Period Prospective Studies Tertiary Care Centers

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