The long-term effects of endometrioma surgery on ovarian reserve: a prospective case–control study

Abstract

The objective of this study was to evaluate the long-term effects of endometrioma excision on ovarian reserve. This study evaluated the long-term effects of endometrioma excision on ovarian reserve. A total of 63 women were enrolled in this prospective case–control study; 21 women had histories of endometrioma surgery (study group), 21 women had diagnoses of endometrioma, and 21 healthy age-matched women served as controls. Participants were recruited from the Department of Obstetrics and Gynecology, Inonu University Faculty of Medicine, between January 2007 and January 2016. The mean follow-up duration after endometrioma surgery was 30.4 ± 18.0 months for the study group. The mean follicle-stimulating hormone, luteinizing hormone and estradiol levels were similar among groups, but the anti-Müllerian hormone (AMH) level was significantly lower in the surgery group than in the control group (p < .001). The mean AMH level was 42% lower in the endometrioma surgery group than in the endometrioma group and 30% lower in the endometrioma group than in the control group (p = .080 and p = .160, respectively). Endometrioma has a detrimental effect on ovarian reserve, and decreased ovarian reserve compared with that in healthy fertile subjects without endometrioma is evident shortly after endometrioma excision. However, the endometrioma excision procedure does not significantly decrease the ovarian reserve in the long term.

Chinese abstract

研究目的：评价子宫内膜异位症手术对卵巢储备的长期影响。本研究评估子宫内膜异位囊肿切除对卵巢储备的长期影响。这项前瞻性病例对照研究共招募了63名女性；21名妇女有子宫内膜异位囊肿切除术史（研究组）, 21名妇女诊断为子宫内膜异位症, 21名年龄匹配的健康妇女作为对照组。自2007年1月至2016年1月在伊诺努大学医学院妇产科招募参与者。研究组子宫内膜异位症术后平均随访时间为30.4 ± 18.0个月。各组的卵泡刺激素, 促黄体生成素和雌二醇平均水平无明显差别, 但手术组的抗苗勒管激素（AMH）水平显著低于对照组（p <.001）。手术组的AMH平均水平比子宫内膜异位症组低42％, 而子宫内膜异位症组比对照组低30％（P值分别为0.080和0.160）。子宫内膜异位症对卵巢储备有不利影响, 与健康受试者相比, 术后短时间内卵巢储备下降是明显的。然而, 手术并不能显著降低卵巢的长期储备。

Keywords:

• Anti-Müllerian hormone
• endometrioma
• long-term effect

Acknowledgements

We received no specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Disclosure statement

The authors have no conflict of interest.