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The Impact of Laparoscopic Cystectomy on Ovarian Reserve in Patients With Unilateral and Bilateral Endometrioma Publisher Pubmed



Mehdizadeh Kashi A1 ; Chaichian S2 ; Ariana S1 ; Fazaeli M1 ; Moradi Y3 ; Rashidi M4 ; Najmi Z5
Authors
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Authors Affiliations
  1. 1. Endometriosis and Gynecologic Disorder Research Center, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Minimally Invasive Techniques Research Center in Women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
  3. 3. Pars Advanced and Minimally Invasive Manners Research Center, Pars General Hospital Tehran, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran

Source: International Journal of Gynecology and Obstetrics Published:2017


Abstract

Objective: To evaluate the effects of laparoscopic cystectomy on serum anti-Mullerian hormone (AMH) level as a marker of ovarian reserve in patients with endometrioma. Methods: A prospective observational study enrolled patients aged younger than 40 years who were referred to a tertiary center in Tehran, Iran, between January 1, 2013 and December 31, 2014 to undergo laparoscopic cystectomy for ovarian endometriomas at least 30 mm in diameter, or regardless of size for patients with infertility, dysmenorrhea, dyspareunia, or dyschezia. Baseline and 6-month post-operative AMH levels were compared. Results: Data from 70 patients were included in the analyses. Among patients with unilateral endometriomas, lower pre-operative AMH levels were observed in patients with endometriomas at least 50 mm in diameter (P=0.027), whereas cyst size was not associated with differences in pre-operative AMH level in patients with bilateral endometriomas (P=0.227). Across the entire study population, post-operative AMH levels were lower than the baseline (P=0.008). Greater post-operative decreases in AMH were associated with bilateral cysts compared with unilateral cysts (P=0.046), cysts being at least 50 mm in diameter among patients with unilateral cysts (P=0.028), and both cysts being at least 50 mm in diameter among patients with bilateral cysts (P=0.025). Conclusion: Laparoscopic cystectomy was associated with post-operative decreases in serum AMH, particularly with bilateral involvement and endometriomas at least 50 mm in diameter. © 2016 International Federation of Gynecology and Obstetrics
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