A prospective cohort study on laparoscopic cystectomy of endometrioma and its effects on ovarian reserve.

OBJECTIVE: To study the effects of laparoscopic surgical resection of ovarian endometrioma on ovarian reserve. METHODS: The prospective cohort study was conducted from March 2014 to March 2019 at private clinics and hospitals in the Kerbala province of Iraq, and comprised women aged 19-42 years complaining of chronic pelvic pain, dysmenorrhea and dyspareunia. The measurement of serum anti-Müllerian hormone and follicular stimulating hormone was done preoperatively on the third day of the menstrual cycle. The levels were compared to those at 1 week and then 3 months postoperatively. Data was analysed using SPSS 20. RESULTS: Of the 332 women with a mean age of 31.36±6.28 years, 9(2.7%) had minimal endometriosis, 23(6.9%) mild, 120(36.1%) moderate and 180(54.2%) had severe endometriosis. There was a significant decrease in serum anti-Müllerian hormone level and increase in follicular stimulating hormone level 1 week postoperatively (p<0.0001) and also at 3 months postoperatively (p<0.0001) compared to the baseline. There was a significant difference between the two cut-off points for both the markers (p≤0.001) postoperatively. CONCLUSIONS: Laparoscopic resection of ovarian endometrioma led to decrease in serum anti-Müllerian hormone level at one week postoperatively then there was gradual increase 3 months postoperatively. The increment serum follicular stimulating hormone level continued even three months postoperatively.