title: Ultrasonographic evaluation and anti-mullerian hormone levels after laparoscopic stripping of unilateral endometriomas.
abstract: OBJECTIVE
  To evaluate the ovarian reserve after laparoscopic stripping of unilateral endometriomas by comparing the operated and non-operated ovaries.
  
  
  METHODS
  Bilateral ovarian volumes, antral follicle counts, and stromal blood flows were assessed by ultrasonography and anti-mullerian hormone (AMH) levels were analysed in 36 patients who had undergone laparoscopic cystectomy for unilateral ovarian endometrioma.
  
  
  RESULTS
  Mean antral follicle counts (AFC) of the operated side ovaries were significantly lower on the second postoperative day (3.1 ± 2.4 vs 5.2 ± 3.7; p<0.05) and in the third month (3.7 ± 2.1 vs 6.4 ± 2.7; p<0.05). Pulsatility indices of the operated ovaries were significantly decreased on the second postoperative day (2.22 ± 0.46 vs 1.76 ± 0.51; p<0.05) while resistance indices were increased (0.81 ± 0.06 vs 0.88 ± 0.13; p<0.05). Doppler parameters had recovered and a non-significant decrease in AMH levels of the patients was recorded in the third month after surgery (2.03 ± 0.41 ng/mL vs 1.95 ± 0.62 ng/mL; p>0.05).
  
  
  CONCLUSIONS
  Although laparoscopic stripping of endometriomas seems to affect the ovarian reserve in terms of AFCs, it does not have a significant negative impact at the end of three months as assessed by ovarian volumes, Doppler indices and AMH levels. Endometrioma surgery techniques are important in preserving normal functioning ovaries and further studies are necessary for optimising these surgical approaches.
authors.affiliation: Gulhane Military Medical Faculty, Obstetrics and Gynecology Department, 06018 Etlik, Ankara, Turkey.
authors.forename: Cihangir Mutlu
authors.initials: CM
authors.lastname: Ercan
authors.forename: Namık Kemal
authors.initials: NK
authors.lastname: Duru
authors.forename: Kazim Emre
authors.initials: KE
authors.lastname: Karasahin
authors.forename: Hakan
authors.initials: H
authors.lastname: Coksuer
authors.forename: Murat
authors.initials: M
authors.lastname: Dede
authors.forename: Iskender
authors.initials: I
authors.lastname: Baser
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004715:Endometriosis / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010053:Ovary / Q000000981:diagnostic imaging; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone