Abstract
Abstract Introduction There is a growing body of evidence that ovarian cystectomy may negatively impact ovarian reserve. It is unclear whether there are any differences in the long-term effect of ovarian reserve after ovarian cystectomy between women with endometrioma and those with other benign ovarian cysts. Although several studies have shown that AMH reduction is milder in nonendometriotic benign ovarian cysts compared with endometriomas, further studies are necessary because long-term studies are lacking. Objective The aim of this study was to compare the long-term effects of laparoscopic cystectomy for endometriotic cysts and other benign cysts on ovarian reserve. Methods A total of 165 women aged 20-40 years who underwent laparoscopic cystectomy for endometriotic cysts (Endometrioma group, n=96) and other benign cysts (Non-endometrioma group, n=69) were included in this retrospective study. Ovarian reserve was measured by serum anti-Müllerian hormone (AMH) and compared before surgery and at 6, 12, 24 and 36 months after surgery. Results Baseline AMH levels were lower in the endometrioma group compared with the non-endometrioma group without statistical significance (4.43±3.52 ng/mL vs. 4.95±3.59 ng/mL; p =0.378). AMH levels of 6, 12, 24, and 36 months after surgery was significantly decreased when compared with preoperative levels in the endometrioma group. Decline of the AMH levels was statistically significant at 6 months and 24 months but not at 12 and 36 months in the non-endometrioma group. There was no further significant decrease in the AMH levels after 6 months of surgery in both groups. Decline of AMH levels at 6, 12, 24, and 36 months after surgery from preoperative levels was significantly larger in the endometrioma group compared with the non-endometrioma group. Conclusions Laparoscopic ovarian cystectomy reduced ovarian reserve irrespective of the type of cysts. Surgical excision of endometriotic cysts has a more detrimental and persistent damage on ovarian reserve compared with other benign ovarian cysts. After 6 months of surgery, no further significant fall in AMH levels was observed in the 36-month follow-up. Disclosure No.
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