Clinical evaluation of ovarian reserve function after laparoscopic cystectomy on unilateral ovarian endometriotic cyst

Abstract

Objective To explore the effect on ovarian reserve function and the sensitive marker after laparoscopic operation on unilateral ovarian endometrioma. Methods From February 2013 to October 2015, a total of 115 women with ovarian cyst underwent laparoscopic cystectomy were included into this study. They were divided into two groups according to histopathological analysis, group A (n=65, histopathological analysis showed ovarian follicle) and group B (n=50, histopathological analysis showed without ovarian follicle). The serum follicle-stimulating hormone (FSH), estradiol and anti-Mullerian hormone (AMH) levels before operation and at seventh day, third month and sixth month after operation were detected, meanwhile, antral follicle count (AFC) and ovarian volume before operation and at seventh day, third month and sixth month after operation were measured by ultrasonic examination. Serum FSH and estradiol levels were detected by electrochemiluminescence immunoassay, and serum AMH levels were detected by enzyme-linked immunosorbent assay (ELISA). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Northern Jiangsu People′s Hospital. Informed consent was obtained from the parents of each participating patients. Results ①There were no significant differences between two groups in the aspects of constitution ratio of older than 35 years old, constitution ratio of ovarian endometriotic cyst diameter≥5 cm, operation duration, bleeding volume, et al (P>0.05). ②The level of serum FSH increased at seventh day after the operation than that before the operation, and the levels of serum estradiol and AMH decreased at seventh day after the operation than that before the operation, which both had significant difference (P 0.05). At the sixth month after the operation, the serum AMH of group A still significant lower than that before the operation (P 0.05). As for group B, there were no significant difference in serum FSH, estradiol and AMH levels compared before the operation(P>0.05). ③ There were no significant differences in serum FSH, estradiol and AMH levels between two groups at every different time points (P>0.05). ④ There were no significant differences between two groups in AFC before operation and at sixth month after the operation (P>0.05). The AFC in group A was less than that of group B at the third month after the operations (P 0.05). Conclusions The ovarian reserve function is influenced after laparoscopic operation on unilateral ovarian endometrioma. The patients with ovarian follicle whose ovarian reserve function was still in the recovery phase at the sixth month after the operation. The serum AMH can be used as a more sensitive marker of ovarian reserve function assessment, it could be a follow-up marker of premature ovarian failure. Key words: Ovarian endometriotic cyst; Laparoscopes; Pathology; Sex hormone; Anti-Mullerian hormone; Women