Laparoscopy Cystectomy still remains the first line as the treatment of endometriosis cyst. A “fertility sparing” laparoscopy is a procedure that preserve uterus and ovaries of endometrioma patient. Objective: was to compare the ovarian reserve before and after laparoscopic cystectomy “fertility sparing” using three marker of ovarian reserve which are AMH, FSH and Estradiol on 2nd or 3rd day of menstrual period and counting the AFC by Transvaginal Ultrasound.Methods: This study is an experimental study on 25 endometrioma patient. Ovarian reserve values was taken before and after laparoscopy using three markers which are AMH, FSH and Estradiol and AFC. All patient included to group performed laparoscopy cyctectomy with several techniques which are no or less use of electrocoagulation, using vassopresin injected to the cyst wall, using stripping of the membrane technique on cyst, without suturing, using compression to control bleeding, avoiding hillus cut. Statistical Analysis was using paired t test method.Result: There was average differences on AMH value before 1,77 ± 0,39 ng/ml and after laparoscopy 1,54 ± 0,38 ng/ml. FSH value before was 6,91 ± 4,59 mlU/ml and after was 10,13 ± 6,51 mlU/ml, for estradiol before was 99,65 ± 77,18 mlU/ml and after was 63,67 ± 35,22 mlU/ml. There were 15 samples before laparoscopy has AFC <4, 10 samples has AFC 4-6, after laparoscopiy there was 8 samples has 8 AFC, 8 samples has 4-6 AFC, and 9 samples has 7-10 AFC. There was a statistical significance on the reduce of ovarian reserve before and after laparoscopic cystectomy “fertility sparing” (p=0,001).Conclusion: There was the affect of laparoscopy cystectomy to the decrease of ovarian reserve which sre 13% decreaed of AMH (p+0,001), 31,6% increased of FSH (p=0,001), estradiol was 47,8% decreaed (p=0,001) and AFC has increased 47.9% (p=0,003). Keywords: Laparoscopic Cystectomy, Endometriosis, Anti Mullerian Hormone, Antral Follicle
Laparoscopy Cystectomy still remains the first line as the treatment of endometriosis cyst. A "fertility sparing" laparoscopy is a procedure that preserve uterus and ovaries of endometrioma patient. Objective: was to compare the ovarian reserve before and after laparoscopic cystectomy "fertility sparing" using three marker of ovarian reserve which are AMH, FSH and Estradiol on 2nd or 3rd day of menstrual period and counting the AFC by Transvaginal Ultrasound. Methods: This study is an experimental study on 25 endometrioma patient. Ovarian reserve values was taken before and after laparoscopy using three markers which are AMH, FSH and Estradiol and AFC. All patient included to group performed laparoscopy cyctectomy with several techniques which are no or less use of electrocoagulation, using vassopresin injected to the cyst wall, using stripping of the membrane technique on cyst, without suturing, using compression to control bleeding, avoiding hillus cut. Statistical Analysis was using paired t test method.
Background : The mullerian duct anomaly is a congenital abnormality of the female reproductive system caused by abnormal embryological development during pregnancy. If accompanied by cervical agenesis and infertility, intervention must be taken. Accurate diagnosis and proper treatment are very crucial to the future of reproduction and treatment of infertility in patients.Objective: Reporting the handling of cases of uterine didelphys accompanied by bilateral cervical agenesis.Method : Case reportCase: Reported cases of women aged 34 years with primary amenorrhea and 9 years primary infertility, not typical cyclic pain, normal secondary sex development and from gynecological examination obtained cervical agenesis. Transvaginal ultrasound examination found a mass with the appearance of adenomyosis. Laparoscopic performed show 2 masses, 1 mass resembling adenomyosis with a size of 9x6x5cm located lateral to the left pelvis and another mass in the form of a hypoplastic uterus with a size of 2x2x1cm visible 2 tubes with 2 ovaries within normal limits. Uterine mass resembling adenomyosis with a location far from the vagina making it difficult to do anastomoses while other uterus hypoplasia and non-functional. Hysterectomies were performed on the mass of adenomyosis with the results of PA was adenomyosis.Conclusion: The uterus didelphys with bilateral cervical agenesis with 1 uterine adenomyosis and located in the pelvic lateral it was difficult to do uterovaginal anastomose so that hysterectomy was performed. Second uterine was hypoplasia and non-functional so that no action was taken. Need to think about "future fertility" in these patients and various options for having children. Keywords: Primary Amenorrhea, Uterine Didelphys, Cervical Agenesis, Adenomyosis
Background : The mullerian duct anomaly is a congenital abnormality of the female reproductive system caused by abnormal embryological development during pregnancy. If accompanied by cervical agenesis and infertility, intervention must be taken. Accurate diagnosis and proper treatment are very crucial to the future of reproduction and treatment of infertility in patients. Objective: Reporting the handling of cases of uterine didelphys accompanied by bilateral cervical agenesis. Method : Case report Case: Reported cases of women aged 34 years with primary amenorrhea and 9 years primary infertility, not typical cyclic pain, normal secondary sex development and from gynecological examination obtained cervical agenesis. Transvaginal ultrasound examination found a mass with the appearance of adenomyosis. Laparoscopic performed show 2 masses, 1 mass resembling adenomyosis with a size of 9x6x5cm located lateral to the left pelvis and another mass in the form of a hypoplastic uterus with a size of 2x2x1cm visible 2 tubes with 2 ovaries within normal limits. Uterine mass resembling adenomyosis with a location far from the vagina making it difficult to do anastomoses while other uterus hypoplasia and non-functional. Hysterectomies were performed on the mass of adenomyosis with the results of PA was adenomyosis. Conclusion: The uterus didelphys with bilateral cervical agenesis with 1 uterine adenomyosis and located in the pelvic lateral it was difficult to do uterovaginal anastomose so that hysterectomy was performed. Second uterine was hypoplasia and non-functional so that no action was taken. Need to think about "future fertility" in these patients and various options for having children.
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