Vera Miodrag Kovačević1, Luka Momir Anđelić1, Ana Mitrović Jovanović2. 1. General Hospital, Department of Obstetrics and Gynaecology, Subotica, Serbia. 2. "Narodni Front" Clinics for Gynaecology and Obstetrics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: anamitrovicjov@gmail.com.
Abstract
OBJECTIVE: To investigate the impact of laparoscopic endometrioma cystectomy on the ovarian reserve and to identify the most important factors that predict the ovarian reserve in patients with endometriomas. DESIGN: Prospective study. SETTINGS: Endoscopy unit of a general hospital. PATIENT(S): Fifty-four patients with unilateral (n = 37) and bilateral endometriomas (n = 17). INTERVENTIONS(S): The serum antimüllerian hormone (AMH) concentration was assessed before surgery and at 6 and 12 months after surgery. MAIN OUTCOME MEASURE(S): The primary outcome was the damage to the ovarian reserve, as assessed by the serum AMH concentration. Secondary end points were the persistence or recovery of ovarian damage after 1 year. RESULT(S): AMH concentrations decreased after the laparoscopic excision of cystic ovarian endometriomas. Before surgery and at 6 and 12 months after surgery, the concentrations were, respectively 3.07, 1.29, and 1.46 ng/mL. In the unilateral group, the median AMH levels were 3.31, 1.43, and 1.72 ng/mL, and in the bilateral group the levels were 2.55, 0.98, and 0.89 ng/mL. The serum AMH concentrations thus decreased by 53.27 ± 38.2% and 49.43 ± 38.3% at 6 and 12 months after cystectomy, respectively. CONCLUSION(S): In patients with endometriomas, the decrease in ovarian reserve occurs immediately after the excision of the endometrioma. Significant predictors of AMH values at 6 and 12 months after surgery include the baseline AMH level, patient age, and bilateral endometriomas.
OBJECTIVE: To investigate the impact of laparoscopic endometrioma cystectomy on the ovarian reserve and to identify the most important factors that predict the ovarian reserve in patients with endometriomas. DESIGN: Prospective study. SETTINGS: Endoscopy unit of a general hospital. PATIENT(S): Fifty-four patients with unilateral (n = 37) and bilateral endometriomas (n = 17). INTERVENTIONS(S): The serum antimüllerian hormone (AMH) concentration was assessed before surgery and at 6 and 12 months after surgery. MAIN OUTCOME MEASURE(S): The primary outcome was the damage to the ovarian reserve, as assessed by the serum AMH concentration. Secondary end points were the persistence or recovery of ovarian damage after 1 year. RESULT(S): AMH concentrations decreased after the laparoscopic excision of cystic ovarian endometriomas. Before surgery and at 6 and 12 months after surgery, the concentrations were, respectively 3.07, 1.29, and 1.46 ng/mL. In the unilateral group, the median AMH levels were 3.31, 1.43, and 1.72 ng/mL, and in the bilateral group the levels were 2.55, 0.98, and 0.89 ng/mL. The serum AMH concentrations thus decreased by 53.27 ± 38.2% and 49.43 ± 38.3% at 6 and 12 months after cystectomy, respectively. CONCLUSION(S): In patients with endometriomas, the decrease in ovarian reserve occurs immediately after the excision of the endometrioma. Significant predictors of AMH values at 6 and 12 months after surgery include the baseline AMH level, patient age, and bilateral endometriomas.
Authors: E van Barneveld; V B Veth; J M Sampat; A M F Schreurs; M van Wely; J E Bosmans; B de Bie; F W Jansen; E R Klinkert; A W Nap; B W J Mol; M Y Bongers; V Mijatovic; J W M Maas Journal: Hum Reprod Open Date: 2020-02-11
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