The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas

Objective: To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas. Design: Prospective study. Setting: Private and university hospitals. Patient(s): A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy. Intervention(s): Serum levels of antimullerian hormone (AMH), FSH, and E-2, as well as antral follicle count (AFC) were measured preoperatively and 1 week, 3 and 9 months postoperatively for AMH, and 3 months for other values. Main Outcome Measure(s): Ovarian reserve based on the comparison of AMH alterations. The secondary end points are changes in FSH, E-2, and AFC. Result(s): Serum AMH level decreased significantly from the baseline (3.86 +/- 3.58 ng/mL) to 1 week (1.66 +/- 1.92 ng/mL), 3 months (2.06 +/- 2.5 ng/mL), and 9 months (1.77 +/- 1.76 ng/mL) postoperatively. Those patients with bilateral endometriomas had significantly lower levels of AMH, 1week, 3 and 9 months after operation. Also, patients older than 38 years had lower postoperative AMH levels. The FSH levels increased significantly from baseline to 3 months postoperatively. The AFC level increased significantly from baseline to 3 months after operation. Conclusion(s): The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas, especially in older patients and those with bilateral cysts. (C) 2014 by American Society for Reproductive Medicine.