title: The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study.
abstract: OBJECTIVE
  To investigate the effect of two different laparoscopic methods on ovarian reserve in patients with ovarian endometriomas.
  
  
  METHODS
  Prospective, randomized clinical trial.
  
  
  METHODS
  Endoscopy unit of a university hospital.
  
  
  METHODS
  Twenty women with endometriomas.
  
  
  METHODS
  Patients were randomly selected to undergo either laparoscopic cystectomy for endometrioma (group 1) or the "three-step procedure" (group 2). Before and 6 months after laparoscopy all patients were evaluated, and 12 months postoperatively they underwent ultrasound scan examination.
  
  
  METHODS
  The primary end point was ovarian reserve damage based on the alterations of anti-Müllerian hormone (AMH). Secondary end points were the changes of antral follicle count and serum concentration of FSH, LH, E(2), and inhibin B.
  
  
  RESULTS
  Mean serum AMH was reduced significantly from 3.9-2.9 ng/mL in group 1 compared with the reduction from 4.5-3.99 ng/mL in group 2.
  
  
  CONCLUSIONS
  Ovarian reserve determined by AMH is less diminished after the three-step procedure compared with cystectomy of endometriomas.
authors.affiliation: Papageorgiou Hospital, 1st Department of Obstetrics & Gynecology, Aristotle University of Thessaloniki, North Efkarpia, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsolakidis
authors.forename: George
authors.initials: G
authors.lastname: Pados
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vavilis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Athanatos
authors.forename: Tryfon
authors.initials: T
authors.lastname: Tsalikis
authors.forename: Anastasia
authors.initials: A
authors.lastname: Giannakou
authors.forename: Basil C
authors.initials: BC
authors.lastname: Tarlatzis
mesh_terms: D000328:Adult; D019468:Disease Management; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009865:Oocytes / Q000000981:diagnostic imaging* / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult