The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis.

Hsin-Ju Chiang,Kuo-Chung Lan,Pin-Yao Lin,Fu-Tsai Kung,Fu-Jen Huang,Yu-Ju Lin,Pei-Hsun Sung

doi:10.1186/s12905-015-0230-1

Hsin-Ju Chiang, Kuo-Chung Lan + Show 5 more

Open Access

https://doi.org/10.1186/s12905-015-0230-1

Copy DOI

Abstract

BackgroundTo investigate the impact of previous ovarian surgery on ovarian reserve in patients with endometriosis.MethodsA total of 829 female patients were recruited. Their medical records were reviewed retrospectively. Patients who had diagnoses of endometriosis or endometrioma were defined as the endometriosis group, and those without endometriosis were as the control group. We further divided these patients into four groups according to whether they had received ovarian surgeries before. Group 1: control group without previous surgery; Group 2: control group with previous surgery; Group 3: endometriosis group without previous surgery; Group 4: endometriosis group with previous surgery. The subgroups with endometrioma or not and different operative procedures were also analyzed. The parameters for comparison included age, body mass index, serum estradiol, follicle-stimulating hormone, luteinizing hormone, cancer antigen 125, and anti-Müllerian hormone (AMH) level.ResultsThe level of serum AMH was highest in group 1 and lowest in group 4. The decline was significant between group 1 and group 4 (p < 0.05). The serum AMH level was lower in group 4 than in group 3 but no significant difference. Serum estradiol level was significantly higher in group 3 than in group 2 (p < 0.05). Cancer antigen 125 levels were both significantly higher in group 3 and group 4 as compared with group 1 and group 2 (p < 0.05).ConclusionsPerforming repeated ovarian surgery in patients with recurrent endometriosis needs careful consideration and adequate patient counselling because of the predictable deteriorating ovarian reserve.

Highlights

To investigate the impact of previous ovarian surgery on ovarian reserve in patients with endometriosis
In order to test our hypothesis that previous ovarian surgery may exacerbate ovarian reserve in patients with endometriosis, the endometriosis and control groups were further divided into four groups: group 1: patients without endometriosis had no history of ovarian surgery; group 2: patients without endometriosis had experienced ovarian survey before this clinical visiting; group 3: patients with endometriosis had no history of ovarian surgery; and group 4: patient with endometriosis had undergone ovarian surgery prior to this visiting
There were 209 (25.2 %) patients allocated in the endometriosis group, and 620 (74.8 %) patients in the control group

Summary

Introduction

To investigate the impact of previous ovarian surgery on ovarian reserve in patients with endometriosis. Anti-Müllerian hormone (AMH) is secreted by pre-antral and antral follicles [1]. Unlike those predictors of ovarian reserve, e.g. basal follicle-stimulating hormone, estradiol, inhibin B, and antral follicle counts, a number of previous studies demonstrated AMH was a steadier marker to predict residual ovarian function (i.e. not being obviously influenced by menstruation) [2,3,4,5]. Changes in serum AMH level in patients with endometriosis have been welldocumented. The impact of ovarian surgery on ovarian reserve in patients with endometriosis is still controversial.

Methods

Results

Conclusion