title: The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis.
abstract: BACKGROUND
  To investigate the impact of previous ovarian surgery on ovarian reserve in patients with endometriosis.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  The 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).
  
  
  CONCLUSIONS
  Performing repeated ovarian surgery in patients with recurrent endometriosis needs careful consideration and adequate patient counselling because of the predictable deteriorating ovarian reserve.
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. n22370@cgmh.org.tw.
authors.forename: Hsin-Ju
authors.initials: HJ
authors.lastname: Chiang
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. m7031@cgmh.org.tw.
authors.forename: Pin-Yao
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. kcgcrm1885@cgmh.org.tw.
authors.forename: Fu-Jen
authors.initials: FJ
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. ftkung@cgmh.org.tw.
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Kung
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. lyu015@cgmh.org.tw.
authors.forename: Yu-Ju
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. e12281@adm.cgmh.org.tw.
authors.forename: Pei-Hsun
authors.initials: PH
authors.lastname: Sung
authors.affiliation: Department of Obstetrics and Gynecology, No.123, DAPI Rd. Niaosng Dist, Kaohsiung City, 83301, Taiwan, R.O.C.. lankuochung@gmail.com.
authors.forename: Kuo-Chung
authors.initials: KC
authors.lastname: Lan
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood; D004715:Endometriosis / Q000097:blood* / Q000503:physiopathology* / Q000601:surgery; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D065851:Ovarian Reserve / Q000502:physiology*; D010053:Ovary / Q000502:physiology*; D012189:Retrospective Studies
chemical_list: D018394:CA-125 Antigen; D004958:Estradiol; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone