Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy

Erğun, Bülent; Özsürmeli, Mehmet; Dündar, Özgür; Comba, Cihan; Kuru, Oğuzhan; Bodur, Serkan

doi:10.1016/j.jmig.2015.05.001

Cited by 38 publications

(27 citation statements)

References 17 publications

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“…In recent studies, AMH serum levels seemed to be the most popular marker for ovarian reserve testing after laparoscopic cystectomy; however, most of the studies focused on short‐term observations. Drops in AMH serum concentration were observed 1 and 3 months after laparoscopic cystectomy and reported in the literature . In a systematic review of 11 publications, Somigliana et al .…”

Section: Discussionmentioning

confidence: 91%

One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts

Kostrzewa

Wilczyński

Głowacka

et al. 2019

Intl J Gynecology & Obste

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Objective:To determine the long-term impact of laparoscopic cystectomy for endometriomas and benign cysts on ovarian reserve and selection of the most effective method of assessment. Methods:The present study was carried out between November 2013 and December 2016. Participants were assigned to laparoscopic cystectomy for diagnosed unilateral benign ovarian cysts and divided into groups: the endometrioma group (EG) (n=35) and the other benign ovarian tumor group (OG) (n=35). Before and at 3 and 12 months after the procedure, transvaginal ultrasonography was performed to assess antral follicle count (AFC) and ovarian volume (OvVol); laboratory tests were ordered for anti-Műllerian hormone (AMH) serum concentration assays. Pregnancy rates were counted in a 12-month follow-up. Statistica12 software was used for analysis. Results:The present study included 70 women aged 18-40 years. AMH serum concentration decreased significantly 3 months after laparoscopic cystectomy (4.89 ± 3.66 ng/mL to 3.45 ± 3.37 ng/mL; P<0.001). A greater decrease of AMH concentrations was observed in the EG (45.39% vs 14.87%; P=0.021). Twelve months of observation revealed a suppression in the drop of the AMH concentration, while AFC and OvVol remained unaffected. The likelihood of spontaneous pregnancy was three times higher in the OG (hazard ratio [HR] 3.57, 95% confidence interval [CI] 1.08-12.5). Conclusion:There was a significant decline in AMH levels in the EG 3 months after cystectomy. No further fall in AMH concentration was observed in the 12-month follow-up. The serum AMH concentration could be considered a valuable marker for ovarian reserve assessment after laparoscopic cystectomy. K E Y W O R D S

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Section: Discussionmentioning

confidence: 91%

One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts

Kostrzewa

Wilczyński

Głowacka

et al. 2019

Intl J Gynecology & Obste

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“…Ergun et al [19] reported in his study that the serum AMH levels were found to decrease following the laparoscopic ovarian cystectomy and this finding could be accepted as an indicator of diminished ovarian reserve. The statistically-significant decrease in postoperative AMH levels were observed in laparoscopic cystectomy operations performed due to either ovarian endometrioma or ovarian cysts other than endometrioma.…”

Section: Discussionmentioning

confidence: 94%

Effect of Laparoscopic Ovarian Cystectomy for Endometrioma on Ovarian Reserve

Elhameid¹,

Amin²,

Alnemr³

et al. 2018

Zagazig University Medical Journal

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Background: To assess the effect of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve by markers as Anti-Mullerian Hormone and Follicle Stimulating Hormone. Subjects: 48 Women of reproductive age who had ultrasonographic diagnosis of endometrioma measuring>3cm whether unilateral or bilateral and subjected to laparoscopic excision. Methods: From January 2017 to December 2017, Women with endometrioma underwent to laparoscopic excision. Serum AMH and FSH were determined preoperatively and 3months postoperative. Results: There was a statistically significant reduction in postoperative mean value of AMH (2.04+ 1.69) when compared to the preoperative mean value of AMH (2.59+ 1.85) and a statistically significant rise in postoperative mean value of serum FSH (7.23+ 1.48), when compared to preoperative mean value of FSH (5.50+ 1.85). Post-operative AMH decreases were greater in patients with endometriomas > 5cm in diameter compared with smaller ones and in patients with bilateral endometriomas compared with unilateral ones. Conclusion: Laparoscopic cystectomy for endometrioma has an adverse impact on ovarian reserve. Bilaterality and size of endometrioma increase the adverse effect of Laparocopic ovarian cystectomy on the ovarian reserve.

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“…A pilot randomized controlled trial in 2013 suggested that AMH levels were not signi cantly different at the baseline in the 4-6 postoperative weeks, in the 3rd postoperative month among women with salpingectomy during laparoscopic hysterectomy versus no salpingectomy [58]. The previous studies showed that serum AMH level is a statistically signi cant decline after ovarian nonendometriotic cystectomy [42,43,45,47]. It was reported that ovarian reserve evaluated with AMH was reduced in patients with ovarian endometriomas when compared with those with other benign ovarian cysts, and with those with healthy ovaries [59].The current study indicated that the ovarian reserve decreased after the surgery, and that in comparison with E2, FSH levels and OARI and AFC, the serum AMH levels could be a convenient and reliable marker for testing ovarian reserve in the short-term.…”

Section: Discussionmentioning

confidence: 99%

“…An undetectable AMH level suggests diminished ovarian reserve and may allow a treatment to be tailored to each individual [17,41]. The recent studies have shown that serum AMH level has been accepted as the most reliable and easily measurable marker for post-operative assessment of ovarian reserve, for it can show a postoperative decline [5,[42][43][44][45][46][47][48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

The time-interval of ovarian reserve recovery after laparoscopic unilateral ovarian nonendometriotic cystectomy: a prospective cohort study

Li¹,

Yan²,

Wang³

et al. 2019

Preprint

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Background: Ovarian benign cyst, frequently seen in women of reproductive age, is one of the most important causes of damaging effect of ovarian reserve. Laparoscopic ovarian cystectomy is established as the gold standard surgical approach to the ovarian benign cyst. Studies have shown that potential fertility can be directly impaired by laparoscopic ovarian cystectomy and diminished ovarian reserve. There is little data about the time-interval of ovarian reserve recovery after the laparoscopic unilateral ovarian cystectomy. The objective of this study was to investigate the time-interval of ovarian reserve recovery after laparoscopic unilateral ovarian nonendometriotic cystectomy.Method: In the first part of the study, a total number of 67 patients with unilateral ovarian nonendometriotic cyst who underwent laparoscopic unilateral ovarian cystectomy were recruited as a postoperative observation group (POG). A total number of 69 same-aged healthy women without ovarian cyst who did not undergo surgery were recruited as a referent group (RFG).The serum anti-Müllerian hormone (AMH) levels were measured using a commercially available enzyme-linked immunosorbent assay kit; the Follicle-stimulating hormone (FSH)and E2 levels, measured using a chemiluminescent reagent kit. The ovarian arterial resistance index (OARI) and AFC were measured by transvaginal ultrasonography on the 3rd-5th day of the same menstrual cycle. In the second part of the study, a prospective postoperative 6-month follow-up of cases was performed. Results: When compared with RFG, the AFC of POG’s cyst side showed no difference in the 1st, 3rd, 6th postoperative month (F = 0.03, 0.02, 0.55; P = 0.873, 0.878, 0.460). The OARI of POG’s cyst side presented no difference in the 1st, 3rd, 6th postoperative month ( F = 0.73, 3.57, 1.75; P=0.395, 0.061, 0.188). In the first month, the postoperative AMH levels declined significantly, 1.88 ng/ml (IQR: 1.61-2.16 ng/ml) in POG and 2.57 ng/ml (IQR: 2.32-2.83 ng/ml) in RFG (F = 13.43; P = 0.000). At the time interval, the rate of decline was significantly lower postoperatively than preoperatively in POG (32.75 %),and was also the case in the comparison of POG with RFG (26.67 %). Conclusions: After the laparoscopic unilateral ovarian cystectomy, the optimal time-interval can be the 6th month for ovarian reserve recovery. Semiannually, AMH levels were to be detected to find those whose window time to conceive was likely to be shorter than others of the same age.

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Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy

Cited by 38 publications

References 17 publications

One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts

One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts

Effect of Laparoscopic Ovarian Cystectomy for Endometrioma on Ovarian Reserve

The time-interval of ovarian reserve recovery after laparoscopic unilateral ovarian nonendometriotic cystectomy: a prospective cohort study

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