title: The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometrioma.
abstract: OBJECTIVE
  To evaluate the effects of laparoscopic cystectomy on serum anti-Müllerian hormone (AMH) level as a marker of ovarian reserve in patients with endometrioma.
  
  
  METHODS
  A prospective observational study enrolled patients aged younger than 40 years who were referred to a tertiary center in Tehran, Iran, between January 1, 2013 and December 31, 2014 to undergo laparoscopic cystectomy for ovarian endometriomas at least 30 mm in diameter, or regardless of size for patients with infertility, dysmenorrhea, dyspareunia, or dyschezia. Baseline and 6-month post-operative AMH levels were compared.
  
  
  RESULTS
  Data from 70 patients were included in the analyses. Among patients with unilateral endometriomas, lower pre-operative AMH levels were observed in patients with endometriomas at least 50 mm in diameter (P=0.027), whereas cyst size was not associated with differences in pre-operative AMH level in patients with bilateral endometriomas (P=0.227). Across the entire study population, post-operative AMH levels were lower than the baseline (P=0.008). Greater post-operative decreases in AMH were associated with bilateral cysts compared with unilateral cysts (P=0.046), cysts being at least 50 mm in diameter among patients with unilateral cysts (P=0.028), and both cysts being at least 50 mm in diameter among patients with bilateral cysts (P=0.025).
  
  
  CONCLUSIONS
  Laparoscopic cystectomy was associated with post-operative decreases in serum AMH, particularly with bilateral involvement and endometriomas at least 50 mm in diameter.
authors.affiliation: Endometriosis and Gynecologic Disorder Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Mehdizadeh Kashi
authors.affiliation: Minimally Invasive Techniques Research Center in Women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Shahla
authors.initials: S
authors.lastname: Chaichian
authors.affiliation: Endometriosis and Gynecologic Disorder Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Shideh
authors.initials: S
authors.lastname: Ariana
authors.affiliation: Endometriosis and Gynecologic Disorder Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Fazaeli
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars General Hospital Tehran, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Moradi
authors.affiliation: Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mandana
authors.initials: M
authors.lastname: Rashidi
authors.affiliation: Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Najmi
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015653:Cystectomy / Q000009:adverse effects*; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007492:Iran; D010535:Laparoscopy / Q000009:adverse effects*; D010048:Ovarian Cysts / Q000601:surgery*; D065851:Ovarian Reserve; D011184:Postoperative Period; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: Anti-Müllerian hormone; Endometrioma; Laparoscopic cystectomy; Ovarian reserve