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

OBJECTIVE: To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas. DESIGN: Prospective study. SETTING: Private and university hospitals. PATIENT(S): A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy. INTERVENTION(S): Serum levels of antimüllerian hormone (AMH), FSH, and E₂, as well as antral follicle count (AFC) were measured preoperatively and 1 week, 3 and 9 months postoperatively for AMH, and 3 months for other values. MAIN OUTCOME MEASURE(S): Ovarian reserve based on the comparison of AMH alterations. The secondary end points are changes in FSH, E₂, and AFC. RESULT(S): Serum AMH level decreased significantly from the baseline (3.86 ± 3.58 ng/mL) to 1 week (1.66 ± 1.92 ng/mL), 3 months (2.06 ± 2.5 ng/mL), and 9 months (1.77 ± 1.76 ng/mL) postoperatively. Those patients with bilateral endometriomas had significantly lower levels of AMH, 1 week, 3 and 9 months after operation. Also, patients older than 38 years had lower postoperative AMH levels. The FSH levels increased significantly from baseline to 3 months postoperatively. The AFC level increased significantly from baseline to 3 months after operation. CONCLUSION(S): The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas, especially in older patients and those with bilateral cysts.