Ovarian reserve and endometrioid ovarian cysts: clinical and ultrasound aspects

The study evaluated laparoscopic and Doppler ultrasound features of endometrioid ovarian cysts in 100 reproductive-age patients with primary infertility, stratified by ovarian reserve using AMH (10 IU/l) versus AMH (>2.0 ng/ml) and FSH (<8 IU/l). Using 2D/3D transvaginal ultrasound with grey-scale and color/power Doppler, and 3D-angiography to assess vascularization before and after surgery, the authors found that in patients with low ovarian reserve, perfusion and vascularization of normal ovarian tissue were significantly lower when cysts were located in the infundibulopelvic and proper ovarian ligament area than with marginal location, whereas in normal-reserve patients intraovarian blood flow was only insignificantly affected. The authors conclude that the effect on ovarian reserve depends on cyst size, location, capsule characteristics, and spread of extragenital endometriosis, noting that cysts 3–5 cm may be associated with either low or high reserve and that cysts >5 cm increased the likelihood of reserve damage by 3.5 times. This paper is centrally about endometriosis — it focuses on ovarian reserve and ultrasound/Doppler findings in patients with endometrioid ovarian cysts.

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