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One‐year follow‐up of ovarian reserve by three methods in women after laparoscopic cystectomy for endometrioma and benign ovarian cysts
Author(s) -
Kostrzewa Marta,
Wilczyński Jacek R.,
Głowacka Ewa,
Żyła Monika,
Szyłło Krzysztof,
Stachowiak Grzegorz
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12884
Subject(s) - medicine , ovarian reserve , antral follicle , anti müllerian hormone , cystectomy , hazard ratio , urology , laparoscopy , gynecology , confidence interval , ovary , endometriosis , pregnancy , hormone , surgery , infertility , bladder cancer , genetics , cancer , biology
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.