The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study.
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.
Tsolakidis
Dimitrios
D
Papageorgiou Hospital, 1st Department of Obstetrics & Gynecology, Aristotle University of Thessaloniki, North Efkarpia, Greece.
Pados
George
G
Vavilis
Dimitrios
D
Athanatos
Dimitrios
D
Tsalikis
Tryfon
T
Giannakou
Anastasia
A
Tarlatzis
Basil C
BC
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