Impact of Endometrioma Treatment on Ovarian Reserve

Munkhbayar Choijiljaw, Yanjinsuren Darmaa, Munkhbayarlakh Sonomjamts, Amarjargal Olzvoi
In: Central Asian Journal of Medical Sciences · 2020 · vol. 6(3) , pp. 177–187 · doi:10.24079/cajms.2020.09.009 · W4312949938
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Laparoscopic cystectomy for ovarian endometrioma significantly reduces serum AMH levels and pain, whereas drug treatment with synthetic progestin alleviates symptoms without affecting ovarian reserve markers.

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This case-control study evaluated ovarian reserve markers in 129 women aged 20 to 46 years diagnosed with ovarian endometrioma. The researchers compared serum anti-Müllerian hormone levels before and after treatment with either synthetic progestins or laparoscopic surgical cystectomy. While medication significantly reduced pain without altering AMH levels, surgery resulted in a statistically significant decrease in AMH from 3.11 to 2.21 ng/mL. The authors note that this reduction in ovarian reserve following surgery may lead to infertility later in life. This paper is centrally about endometriosis — specifically the impact of laparoscopic excision on ovarian reserve in patients with endometriomas.

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Abstract

Objectives: To evaluate the ovarian reserve by measuring AMH level after the both treatment of drug and surgery for Endometrioma. Methods: We studied 129 patients who have diagnosed with ovarian endometrioma, aged 20-46 years, using case-control study design. There are 4 groups with medication and surgeries. Results: There were significant reduction of pain in patients who received synthetic progestin (p = 0.001) groups. Serum AMH were 3.48 ± 0.9 before treatment and 3.41 ± 1.0 after treatment respectively (p = 0.456). Prior treatment of laparoscopic surgery with progestin 3 months, it decreases abdominal lower pain (p = 0.001) and dysmenorrhea (p = 0.001). Serum AMH level were 3.11 ± 1.8 before surgery and 2.21 ± 0.2 after surgery, respectively (p = 0.005). Conclusions: Laparoscopic surgery might be decrease ovarian reserve which leads to infertility later life in women who has ovarian endometrioma with ovarian cystectomy.
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Keywords

Ovarian Endometrioma, Laparoscopic Surgery, Infertility, Synthetic Progestin, Antral FollicleAbstract

Objectives

To evaluate the ovarian reserve by measuring AMH level after the both treatment of drug and surgery for Endometrioma. Methods: We studied 129 patients who have diagnosed with ovarian endometrioma, aged 20-46 years, using case-control study design. There are 4 groups with medication and surgeries. Results: There were significant reduction of pain in patients who received synthetic progestin (p = 0.001) groups. Serum AMH were 3.48 ± 0.9 before treatment and 3.41 ± 1.0 after treatment respectively (p = 0.456). Prior treatment of laparoscopic surgery with progestin 3 months, it decreases abdominal lower pain (p = 0.001) and dysmenorrhea (p = 0.001). Serum AMH level were 3.11 ± 1.8 before surgery and 2.21 ± 0.2 after surgery, respectively (p = 0.005). Conclusions: Laparoscopic surgery might be decrease ovarian reserve which leads to infertility later life in women who has ovarian endometrioma with ovarian cystectomy. 610 Downloads Published How to Cite Issue Section License Copyright (c) 2020 Mongolian National University of Medical Sciences This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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endometriomadysmenorrheainfertility

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