The Impact of Laparoscopic Ovarian Cystectomy on Ovarian Reserve in Cases of Endometrioma

Abstract

Background: An endometrioma is one of the most common manifestations of endometriosis. Laparoscopic cystectomy is the preferred approach to managing bengin ovarian cysts in adolescents and adults, but unfortunately it affects the ovarian reserve. Aim of the work: This study was aimed to evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas. Patients and methods: This prospective study was conducted on 44 cases suffering from ovarian endometriomas and subjected to laparoscopic cystectomy. The patients in the study were selected from the Outpatient Clinic in Sayed Galal University Hospital and EL-Gala Maternity Teaching Hospital. This study was conducted between April 2017and March 2018. Serum anti-mullerian hormone (AMH), FSH and E2, as well as the antral follicle count (AFC) were measured preoperatively and 3 months postoperatively. Main outcome measures: Ovarian reserve based on the comparison of AMH alterations. The secondary end points are changes in FSH, E2 and AFC. Results: There was a statistically significant reduction in postoperative median, values of AFC, serum, AMH, serum E2 and serum E2: FSH ratio, and a statistically significant rise in postoperative median serum FSH, when compared to preoperative measurements in included women. Conclusion: The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas, especially in older patients and those with bilateral cysts.