Ovarian Reserve Reduction With Surgery Is Not Correlated With the Amount of Ovarian Tissue Inadvertently Excised at Lapa
- PDF / 137,638 Bytes
- 6 Pages / 602.986 x 782.986 pts Page_size
- 11 Downloads / 161 Views
Reproductive Sciences 1-6 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1933719119828055 journals.sagepub.com/home/rsx
Ludovico Muzii, MD1, Chiara Di Tucci, MD1, Mara Di Feliciantonio, MD1, Giulia Galati, MD1, Irene Pecorella, MD2, Antonio Radicioni, MD3, Antonella Anzuini, MD3, Maria Grazia Piccioni, MD1, Felice Patacchiola, MD4, and Pierluigi Benedetti Panici, MD1
Abstract The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Mu¨llerian 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 ¼ .68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P ¼ .003), and of 63.1% at 3 months (1.25 [1.00]; P ¼ .007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (þ9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 (P ¼ .012), and by 29.5% in group 2 (P ¼ .200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas (P ¼ .006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas (P ¼ .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. Keywords anti-Mu¨llerian hormone (AMH), endometrioma, cystectomy, ovarian reserve
Introduction Endometriosis is defined as the presence of endometrial-like tissue outside the uterus and is associated with dyspareunia, dysmenorrhea, chronic pelvic pain, and infertility. Endometriomas occur in 17% to 44% of women with endometriosis.1-3 The gold standard for the surgical treatment of endometriomas is laparoscopic excision with the stripping technique since this technique is associated with better results in terms of pregnancy rates, pain control rates, and cyst recurrence rates, compared with fenestration and coagulation/ablation of the cyst wall.4-7 The limit of surgical excision with the stripping technique is the possible damage to the ovarian reserve due to accidental removal of healthy ovarian tissue as evidenced by recent data
from the literature.8 Ovarian reserve is defined as the functional potential of the ovary and reflects the numbe
Data Loading...
