Antral Follicle Count and Serum Anti-mullerian Hormone in Patient with Endometriomas Pre and Post Endometriotic Surgery (Open Versus Laparoscopic) for Assessment of Ovarian Reserve

Background: When the stroma and epithelial tissues that make up the endometrium implant outside of the uterus, a condition known as endometriosis occurs. Although some endometriosis patients may experience moderate or no symptoms at all, the most common ones include dyspareunia, persistent pelvic pain, dysmenorrhea, menorrhagia, gastrointestinal (GI) issues, and urinary symptoms. Aim: Examining endometrioma patients' blood anti-mullerian hormone levels and antral follicle counts before and after endometriotic surgery. Subjects and methods: From April 2023 through April 2025, one hundred patients were enrolled in this prospective observational study at the Obstetrics and Gynecology department at Al-Azhar University Hospitals in Cairo, Egypt. The participants were categorized as follows: Patients receiving open cystectomy (Group A) and endometrioma removal (Group B) through laparoscopic surgery. Results: In terms of ovarian reserve, Group B showed a statistically significant decline compared to Group A. Concerning the ultrasound examination and the hysteroscopy examination, no statistically significant difference was found between the groups that were tested. While the groups did not differ significantly with respect to AMH and AFC values before surgery, they did differ significantly with respect to AMH and AFC values after surgery. Conclusion: Group B appears to be more beneficial than Group A in preserving ovarian reserve post-surgery. It also offers the advantage of shorter operative times. This study suggests that laparoscopic surgery may be a preferable option for patients with endometriomas who wish to maintain their ovarian function.