Ovarian Reserve Reduction With Surgery Is Not Correlated With the Amount of Ovarian Tissue Inadvertently Excised at Laparoscopic Surgery for Endometriomas

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Laparoscopic cystectomy for endometriomas significantly reduced ovarian reserve as measured by AMH, with the decrease not correlating to the amount of inadvertently excised ovarian tissue.

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This study evaluated whether laparoscopic cystectomy for ovarian endometriomas affects ovarian reserve, using serial serum anti-Müllerian hormone (AMH) measurements before surgery and at 1, 3, and 6 months afterward, compared with women undergoing surgery for other benign ovarian cysts. In 52 participants operated on by a single experienced surgeon, AMH declined significantly in the endometrioma group by 43.4% at 1 month, by 63.1% at 3 months, and by 59.3% at 6 months, while the control cyst group showed a smaller, non-significant 29.5% reduction at 6 months. The decrease in AMH after endometrioma surgery did not correlate with the number of inadvertently removed follicles measured histologically (P = .669). This paper is centrally about endometriosis—laparoscopic surgery for ovarian endometriomas and its relationship to ovarian reserve as reflected by AMH.

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Abstract

The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Müllerian hormone (AMH) serial measurements and to compare AMH values with the number of inadvertently removed follicles in histological specimens. Fifty-two women were enrolled: 34 patients with endometriomas (group 1) and 18 patients with other benign ovarian cysts (group 2). All patients underwent laparoscopic cystectomy performed by a single experienced surgeon. The AMH was measured before, and 1, 3, and 6 months after cystectomy in group 1, and before and 6 months after surgery in group 2. Preoperative AMH levels (mean [standard deviation, SD]) in group 1 (3.39 [2.43] ng/mL) were not significantly different from group 2 (3.74 [2.57] ng/mL; P = .68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P = .003), and of 63.1% at 3 months (1.25 [1.00]; P = .007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (+9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 (P = .012), and by 29.5% in group 2 (P = .200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas (P = .006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas (P = .669). In conclusion, AMH decreases significantly after surgical excision of ovarian endometriomas. The postoperative decrease does not appear to correlate with the amount of ovarian tissue inadvertently excised with the endometrioma wall.
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Abstract

The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Müllerian hormone (AMH) serial measurements and to compare AMH values with the number of inadvertently removed follicles in histological specimens. Fifty-two women were enrolled: 34 patients with endometriomas (group 1) and 18 patients with other benign ovarian cysts (group 2). All patients underwent laparoscopic cystectomy performed by a single experienced surgeon. The AMH was measured before, and 1, 3, and 6 months after cystectomy in group 1, and before and 6 months after surgery in group 2. Preoperative AMH levels (mean [standard deviation, SD]) in group 1 (3.39 [2.43] ng/mL) were not significantly different from group 2 (3.74 [2.57] ng/mL; P =.68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P =.003), and of 63.1% at 3 months (1.25 [1.00]; P =.007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (+9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 (P =.012), and by 29.5% in group 2 (P =.200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas (P =.006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas (P =.669). In conclusion, AMH decreases significantly after surgical excision of ovarian endometriomas. The postoperative decrease does not appear to correlate with the amount of ovarian tissue inadvertently excised with the endometrioma wall. Similar content being viewed by others

References

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Ovarian Reserve Reduction With Surgery Is Not Correlated With the Amount of Ovarian Tissue Inadvertently Excised at Laparoscopic Surgery for Endometriomas. Reprod. Sci. 26, 1493–1498 (2019). https://doi.org/10.1177/1933719119828055 Published: Version of record: Issue date: DOI: https://doi.org/10.1177/1933719119828055

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endometriosisendometrioma

MeSH descriptors

Endometriosis Laparoscopy Ovarian Cysts Ovarian Reserve Ovary Postoperative Complications Adult Endometriosis Endometriosis Endometriosis Female Follow-Up Studies Humans Laparoscopy Laparoscopy Ovarian Cysts Ovarian Cysts Ovarian Cysts Ovarian Reserve Ovary

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