title: Second surgery for recurrent unilateral endometriomas and impact on ovarian reserve: a case-control study.
abstract: OBJECTIVE
  To investigate the impact on ovarian reserve of second laparoscopic surgery for recurrent unilateral endometriomas.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  This study included patients who underwent stripping of endometriomas (diameter ≥4 cm) and were followed-up at our institution. Case subjects had second surgery for recurrent unilateral endometriomas (n = 18); control subjects had no recurrence and no second surgery (n = 18).
  
  
  METHODS
  This case-control study was based on a retrospective analysis of a prospectively collected database including patients who underwent surgery for endometriomas at our institution.
  
  
  METHODS
  The primary outcome of the study was to assess the changes in antimüllerian hormone (AMH) levels in each study group and between the two study groups. The secondary outcomes of the study were to assess the changes in basal FSH, antral follicle count (AFC), and ovarian volume in each study group and between the two study groups.
  
  
  RESULTS
  In both study groups, primary surgery decreased AMH, increased basal FSH, and decreased the AFC of the operated ovary. Before second surgery, case subjects had AMH, basal FSH, and AFC similar to control subjects. After second surgery, case subjects had lower AMH, higher basal FSH, and lower AFC of the affected ovary than before surgery; the volume of the operated ovary was lower than that of the contralateral ovary.
  
  
  CONCLUSIONS
  The laparoscopic stripping of recurrent ovarian endometriomas is associated with a high risk of ovarian reserve damage and ovarian failure.
  
  
  BACKGROUND
  NCT02047838.
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy. Electronic address: simone.ferrero@unige.it.
authors: Simone
authors: S
authors: Ferrero
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Carolina
authors: C
authors: Scala
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Annalisa
authors: A
authors: Racca
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Luana
authors: L
authors: Calanni
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Valentino
authors: V
authors: Remorgida
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Pier Luigi
authors: PL
authors: Venturini
authors: Obstetrics and Gynecology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy.
authors: Umberto
authors: U
authors: Leone Roberti Maggiore
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016208:Databases, Factual; D004715:Endometriosis / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D043373:Follicle Stimulating Hormone, Human; D006785:Hospitals, University; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects*; D009929:Organ Size; D006080:Ovarian Follicle; D010050:Ovarian Function Tests; D065851:Ovarian Reserve; D010053:Ovary / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D011237:Predictive Value of Tests; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human; D054304:Anti-Mullerian Hormone
keywords: AMH; antral follicle count; endometriosis; laparoscopy; ovarian reserve