The Optimal Time of Ovarian Reserve Recovery After Laparoscopic Unilateral Ovarian Non-Endometriotic Cystectomy

Li, Huaping; Yan, Bin; Wang, Yanli; Shu, Zhiming; Li, Ping; Liu, Yahong; Wang, Ying; Ni, Xiaohong; Liu, Zhou

doi:10.3389/fendo.2021.671225

Cited by 9 publications

(10 citation statements)

References 40 publications

(44 reference statements)

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“…It could mean that in reproductive age this female's window of opportunity to conceive may be shorter compared to females of the same age who have not undergone ovarian cystectomy. This result coincide with the findings of Li et al 10 …”

Section: Discussionsupporting

confidence: 94%

“…7,9 Previous publications have shown a reduction in the ovarian reserve after a surgical intervention on the ovaries. [10][11][12][13][14][15] Ovarian reserve (OR) refers to the reproductive potential and reflects the number of follicles left in the ovary. 11 Cycle-day-independent anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), and antral follicle counts (AFC) are used to determine the OR.…”

mentioning

confidence: 99%

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Influence of ovarian cysts on ovarian reserve and fertility: A case–control study

Bareghamyan,

Chopikyan,

Petrosyan

et al. 2023

Intl J Gynecology & Obste

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ObjectiveThe aim of this study was to evaluate the impact of having an ovarian cyst and undergoing cystectomy on the expression of ovarian reserve markers among adolescent females who live in Armenia.MethodsWe conducted a prospective case–control study. Cases were arranged into two groups. The postoperative group (POG) included those who underwent unilateral ovarian cystectomy, and those in the benign ovarian cyst group (BOCG) had complex ovarian cysts with a diameter of 5 cm or more. Adolescents without ovarian pathologies were included in the reference group (RFG). Levels of anti‐Mullerian hormone (AMH) and follicular stimulating hormone (FSH) were measured, and an ultrasound investigation of antral follicular count (AFC) was also done.ResultsMean differences between baseline and 6‐month follow‐up levels of AMH, AFC significantly decreased in both the POG and BOCG compared to the RFG. However, the decrease was more significant in the POG: a decrease of 0.86 ng/mL for AMH and 3.11 ng/mL for AFC versus decreasing by 0.61 ng/mL for AMH and 1.68 ng/mL for AFC. Meanwhile, in the BOCG, 6‐month FSH levels did not show any significant changes compared to the baseline measurement. In comparison with the reference group, there was a significant decrease in the levels of AMH and AFC among participants who had endometriomas and cystadenomas.ConclusionBenign ovarian cysts 5 cm or more in diameter, as well as cystectomy, statistically affect OR after 6 months. Therefore, adolescents with ovarian cyst or cystectomy need individualized support to maintain reproductive age fertility.

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Section: Discussionsupporting

confidence: 94%

mentioning

confidence: 99%

Influence of ovarian cysts on ovarian reserve and fertility: A case–control study

Bareghamyan,

Chopikyan,

Petrosyan

et al. 2023

Intl J Gynecology & Obste

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“…Also the endometrioma itself may cause damage to the surrounding ovarian tissue, with decreasing serum AMH level 22 . Reduced ovarian reserve postoperatively is reported to recover at approximately 3–6 months 23 , 24 . Recovery of ovarian reserve could be attributed to the reperfusion of ovarian tissue, activation and rearrangement of ovarian follicles 2 , 25 .…”

Section: Discussionmentioning

confidence: 99%

Changes in anti-Müllerian hormone values for ovarian reserve after minimally invasive benign ovarian cystectomy: comparison of the Da Vinci robotic systems (Xi and SP) and the laparoscopic system

Park,

Song,

Jee

et al. 2024

Sci Rep

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To investigate the impact on the ovarian reserve after minimally invasive ovarian cystectomy using two platforms, the Da Vinci robotic system (Xi and SP) and the laparoscopic system. Patients underwent laparoscopic or Da Vinci robotic (Xi or SP) ovarian cystectomy for benign ovarian cysts between January 1, 2018, and December 31, 2022 at Guro Hospital, Korea University Medical center. We measured the change of AMH values (%) = [(postAMH − preAMH)] × 100/preAMH. No significant differences in preoperative age, cyst size, estimated blood loss during surgery, hemoglobin drop, length of hospital stay, adhesion detachment rate and cyst rupture rate were observed. However, the operative time was significantly shorter in the laparoscopic group than that in the robotic group (67.78 ± 30.58 min vs. 105.17 ± 38.87 min, p < 0.001) The mean preAMH and postAMH were significantly higher with the Da Vinci robotic group than with the laparoscopic group (preAMH: 5.89 ± 4.81 ng/mL vs. 4.01 ± 3.59 ng/mL, p = 0.02, postAMH: 4.36 ± 3.31 ng/mL vs. 3.08 ± 2.60 ng/mL, p = 0.02). However, the mean ΔAMH was not significantly different between two groups. ΔAMH also did not demonstrate significant differences among the three groups; laparoscopic, Xi and SP robotic. Even in the patient groups with preAMH < 2 and diagnosed with endometriosis, the ΔAMH did not show significant differences between the laparoscopic and robotic groups. The Da Vinci robotic system is no inferior to conventional laparoscopic systems in preserving ovarian function.

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“…Hoang Tong et al found that unilateral ovarian cystectomy with a 43.4–48% decrease in serum AMH from 1 to 6 months after surgery was the same as the cystectomy results performed in the early follicular phase in this study [ 34 ]. Zhou Liu et al estimated the distance to restore ovarian reserve after laparoscopic unilateral ovarian cystectomy to be six months [ 35 ]. Urman et al found a significant decrease in AMH concentration and antral follicle count (AFC) one month after surgery, a reduction that persisted six months postoperatively [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

The optimal time for laparoscopic excision of ovarian endometrioma: a prospective randomized controlled trial

Wu,

Yang,

Lin

et al. 2023

Reprod Biol Endocrinol

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Objective This study aimed to explore the optimal time of laparoscopic cystectomy for unilateral ovarian endometrioma patients and evaluate the influence on ovarian reserve. Materials and methods This prospective randomized controlled study included 88 women with unilateral ovarian endometrioma at a tertiary teaching hospital. All patients received their first identified diagnosis of ovarian endometrioma by ultrasound (> 4 cm and ≤ 10 cm) and were administered an oral contraceptive pill (OC) for one cycle before laparoscopy. They were randomly divided into two groups: laparoscopy at the late luteal phase (group LLP) (n = 44) (termination of OC for two days) and laparoscopy at the early follicular phase (group EFP) (n = 44) (day 3 after menstruation). Basic clinical characteristics were recorded. Serum Anti-Müllerian hormone (AMH) levels were measured at various times to predict ovarian reserve. Serum levels of Anti-Müllerian hormone (AMH) were measured at several time sites to predict the ovarian reserve; AMH and leukocyte esterase (LE) levels of the endometrioma wall were measured. Results Before surgery, serum AMH levels decreased in both groups from preoperative to one week and six months postoperatively. In contrast, the difference values of group EFP were larger than those of group LLP at postoperative one week and postoperative six months (1.87 ± 0.97 vs. 1.31 ± 0.93, P = 0.07; 1.91 ± 1.06 vs. 1.54 ± 0.93, P = 0.001). The mean rates of postoperative serum AMH decline were 37.92% and 46.34% in group EFP, significantly higher than those in group LLP (25.83% vs. 31.43%, P < 0.001). Ovarian endometrioma wall AMH of group LLP was significantly lower than that of group EFP ([22.86 ± 3.74] vs. [31.02 ± 5.23], P < 0.001). Meanwhile, ovarian endometrioma LE concentration of group LLP was significantly higher than that of group EFP ([482.83 ± 115.88] vs. [371.68 ± 84.49], P<0.001). There was also a significant inverse correlation between leukocyte esterase and AMH concentration in an ovarian endometrioma cyst wall (r=-0.564, P<0.001). Conclusion(s) The optimal time for laparoscopic cystectomy for patients with first identified unilateral ovarian endometrioma is the late luteal phase, which reduces ovarian tissue loss and preserves ovarian reserve effectively and safely.

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The Optimal Time of Ovarian Reserve Recovery After Laparoscopic Unilateral Ovarian Non-Endometriotic Cystectomy

Cited by 9 publications

References 40 publications

Influence of ovarian cysts on ovarian reserve and fertility: A case–control study

Influence of ovarian cysts on ovarian reserve and fertility: A case–control study

Changes in anti-Müllerian hormone values for ovarian reserve after minimally invasive benign ovarian cystectomy: comparison of the Da Vinci robotic systems (Xi and SP) and the laparoscopic system

The optimal time for laparoscopic excision of ovarian endometrioma: a prospective randomized controlled trial

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