Decreased anti-Müllerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis

Lemos, Nadiane Albuquerque; Arbo, Elisângela; Scalco, R.; Weiler, Eduardo M.; Rosa, Virgínia de Oliveira; Cunha-Filho, João Sabino

doi:10.1016/j.fertnstert.2007.04.048

Cited by 104 publications

(80 citation statements)

References 22 publications

(30 reference statements)

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“…These include the following: mechanical obstruction caused by pelvic adhesions, impaired embryo receptivity and implantation, local and systemic inflammatory state with increased concentration of cytokines in peritoneal fluid, and low ovarian reserve [16]. Progressive loss of follicle reservoir is frequently observed and is often responsible for impaired fecundity, poor results achieved by assisted reproduction [17,18] and increased risk of POF [19]. Accelerated depletion of ovarian reserve is most threatening for patients who are not seeking a pregnancy at present, but are very much interested in preserving chances for conceiving a biological offspring in the future.…”

Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

“…Nevertheless, several cycles might be required, especially in patients with low ovarian reserve, in order to aspirate an adequate numbers of oocytes (around [12][13][14][15][16][17][18][19][20] that may provide a realistic chance for future fertility. Number of COH and IVF cycles has not been associated with an increased risk of disease recurrence [46,47].…”

Section: Embryo/egg Freezingmentioning

confidence: 99%

“…Even in young patients, several cycles might be needed in order to collect an adequate number of oocytes (12)(13)(14)(15)(16)(17)(18)(19)(20). For patients designated for an extensive or bilateral pelvic surgery, several ART cycles before surgery may provide a sufficient number of oocytes/embryos for freezing.…”

Section: Approach To Patients and Conclusive Remarksmentioning

confidence: 99%

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The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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Patients affected with severe endometriosis are at significant risk for ovarian tissue damage, which may lead to infertility, reduced response to ovarian stimulation, and occasionally, premature ovarian failure. The risk for a compromised ovarian reserve in young patients is especially high following repeated surgical intervention and in the presence of bilateral endometriomas. In many cases, enhanced loss of ovarian reserve may also result from the damaging effect of the pathologic process on follicle reservoir even without surgical interventions. Women diagnosed with severe endometriosis and those designated for extensive ovarian surgical intervention are frequently not planning to conceive. In light of recent advances in fertility preservation techniques (FPT), such as oocytes and ovarian tissue freezing, as well as their increasing success rates, we critically evaluate the options for FPT in patients suffering from endometriosis. Personalized counseling should be offered to all patients with endometriosis taking into account age, extent of ovarian involvement, current ovarian reserve, previous and impending surgeries for endometriosis, along with current success rates and possible risks associated with FPT.

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Section: Reduced Ovarian Reserve In Patients Affected By Endometriosismentioning

confidence: 99%

Section: Embryo/egg Freezingmentioning

confidence: 99%

Section: Approach To Patients and Conclusive Remarksmentioning

confidence: 99%

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The role of fertility preservation in patients with endometriosis

Carrillo

Seidman

Cittadini

et al. 2016

J Assist Reprod Genet

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“…Remarkable declines in serum AMH were reported in patients with moderate to sever endometriosis, which was more pronounced in those with bilateral endometrioma. 25,[31][32][33][34][35][36] Ovaries with endometrioma may already have some damage with decreased ovarian reserve. [24][25][26] Lower anti-mullerian hormone serum levels and association with the severity of the disease found in women with endometriosis.…”

Section: Discussionmentioning

confidence: 99%

“…Till today a number of studies have shown that the presence of endometriosis has been shown to be associated with a decrease in the follicular ovarian reserve accompanied by a reduction in AMH levels. 25,31,37 Several mechanisms by which the endomterioma progressively affects the ovarian tissue have been identified. Colour Doppler transvaginal ultrsonography shows interstitial devascularization in the ovarian endometrioma bed and confirmed that fibrosis and miscrovascular injury were a potential cause of reduced follicle reserve.…”

Section: Discussionmentioning

confidence: 99%

Endometrioma is a Responsible Factor for Reduced Ovarian Reserve

Begum

Ehsan²,

Ehsan³

et al. 2016

Bangladesh J Obstet Gynaecol

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Objective (s): The aim of the study was to assess ovarian reserve (OR) of patients with endometrioma and to explore the differences of ovarian reserve in age matched group of infertile patients without endometrioma.Materials and methods: This prospective analytic study was done in Infertility Care and Research Center, between January 2013 and December 2015 to assess the ovarian reserve of patients with endometrioma. During this period 105 patients of endometriosis with endometrioma were selected for study. Selection criteria were: no history of previous surgery, <36 years of age, no history of endocrine problems, no history of recent medical treatment for this condition within 6 months and no history of irregular menstruation. For ovarian reserve testing we assessed serum FSH, E2 and AMH. Patient of same age group who had no emdometrioma, no history of any surgery, no menstrual irregularity, endocrine disorder or any other medical diseases were taken as control to compare the ovarian reserve between these two groups. For control group also we did the same tests. Data was analyzed by SPSS package. One-way ANOVA test was done for test of significance. A p-value of <0.05 was considered as significant.Results: There was no difference in characteristics of patients of both groups regarding age, type of infertility and duration of infertility. Size of the endometriotic cysts were variable and average diameter of cyst was 6.2 ±2.32 cm. Most (58.10%) of the cysts were unilateral. There is a significant difference of FSH and AMH level between the groups. FSH of endometrioma and non-endometrioma group was 7.9 ±1.17 and 7.1 ±1.05 mIU/mL respectively with a p value of 0.029. Similar difference was present in AMH level, which was 2.42 ±.63 and 2.98 ±.88 ng/ mL in endometrioma and non-endometrioma group respectively with a p value of 0.020.Conclusion: This small study shows a reduced ovarian reserve in patients with endometrioma in comparison to patients of same parameters without endometrioma. It suggests that there is an association of presence of ovarian endometrioma and reduced ovarian reserveBangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 98-104

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Ovarian reserve markers of women with superficial endometriosis

Lessans,

Gilan,

Dick

et al. 2023

Intl J Gynecology & Obste

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ObjectiveEndometriosis affects up to 10% of reproductive age women and is associated with pelvic pain and subfertility. While previous studies have shown an association between deep and ovarian endometriosis to reduced ovarian reserve, there is no data on the effect of superficial endometriosis on ovarian reserve markers. Hence, we aimed to compare ovarian reserve markers of women with superficial endometriosis to that of women without endometriosis.MethodsThis was a case control study in a tertiary medical center. The study group included women aged 18–40 with surgically and histopathology‐proven superficial endometriosis with no deep lesions or ovarian involvement. The control group included women with no known or suspected endometriosis and was matched to the study group by age, BMI and parity. We excluded women with other known risk factors for ovarian failure and with other gynecological disorders. Participants completed a questionnaire with demographic, medical and gynecological data. Each patient underwent anti‐Mullerian hormone (AMH) testing and an ultrasound to assess their antral follicular count (AFC). AMH and AFC were then compared between groups.ResultsA total of 124 women participated in the study. Of these, 50% (n = 62) had surgically proven superficial endometriosis and 50% (n = 62) were without known or suspected endometriosis. Mean AMH levels of women with and without superficial endometriosis was 3.0 ± 2.8 ng/mL and 2.8 ± 1.9 ng/mL, respectively (P = 0.71). AFC also did not differ between groups (women with superficial endometriosis: 12.0 ± 6.6; women without endometriosis: 10.2 ± 5.0, P = 0.15).ConclusionsIn our cohort, superficial endometriosis was not associated with diminished ovarian reserve. While further studies are needed, to date, it does not appear to be justified to assess ovarian reserve for patients with superficial endometriosis.

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Decreased anti-Müllerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis

Cited by 104 publications

References 22 publications

The role of fertility preservation in patients with endometriosis

The role of fertility preservation in patients with endometriosis

Endometrioma is a Responsible Factor for Reduced Ovarian Reserve

Ovarian reserve markers of women with superficial endometriosis

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