Ovarian reserve after dienogest therapy versus laparoscopic cystectomy for unilateral endometriomas: A randomized clinical trial

Khaled A. Atwa, Zakia M. Ibrahim, Eman M. El Bassuony, Omima T. Taha, S Ibrahim, Mohamed F. Ibrahim
In: Journal of Endometriosis and Pelvic Pain Disorders · 2024 · vol. 16(1) , pp. 17–23 · doi:10.1177/22840265241230717 · W4391883386
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Dienogest therapy preserved ovarian reserve, as indicated by increased antral follicle count and anti-Müllerian hormone, whereas laparoscopic cystectomy led to significant decreases in these markers.

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Abstract

Objective: To assess the effect of Dienogest versus surgical management of endometriomas on ovarian reserve. Methods: This randomized clinical trial was conducted at Suez Canal university hospital from November 1st, 2020, to July 31st, 2022. We recruited patients with endometriomas according to particular inclusion and exclusion criteria. The study population was allocated into two groups: group one received Dienogest, and group two had laparoscopic cystectomy. Eligible patients were subjected to history and examination to evaluate pelvic pain using the Biberoglu and Behrman score and the visual analogue scale. Ultrasound examination was done to diagnose ovarian endometrioma and its diameter. Ovarian reserve was evaluated by the antral follicle count and serum anti-mullerian hormone. After 3 months, patients were reevaluated regarding cyst diameter, antral follicle count, pain scores, and the anti-mullerian hormone. The primary outcome measure was to evaluate the ovarian reserve before and after intervention in both groups. Results: The antral follicle count and anti-mullerian hormone increased significantly after Dienogest therapy and decreased significantly after surgical excision ( p < 0.001). Only induration was significantly decreased in the medical treatment group ( p < 0.001). Both management options resulted in a noticeable reduction in the visual analogue scale scores in each group individually. Conclusion: Dienogest rescued ovarian reserve in women with endometriomas.
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Data availability statement Authors Metrics and citations Metrics Journals metrics This article was published in Journal of Endometriosis and Pelvic Pain Disorders. View All Journal MetricsPublication usage* Total views and downloads: 868 *Publication usage tracking started in December 2016 Publications citing this one Receive email alerts when this publication is cited Web of Science: 1 view articles Opens in new tab Crossref: 2 - Endometriosis-associated infertility and the efficacy of dienogest - Comparative impact of 3D and 2D laparoscopy on ovarian reserve following endometrioma excision: A retrospective study Figures and tables Figures & Media Tables View Options Access options If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below: loading institutional access options Alternatively, view purchase options below: Purchase 24 hour online access to view and download content. Access journal content via a DeepDyve subscription or find out more about this option.

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Biberoglu-Behrman

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endometrioma

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