The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study

Dimitrios Tsolakidis, George Pados, Dimitrios Vavilis, Dimitrios Athanatos, Tryfon Tsalikis, Anastasia Giannakou, Basil C. Tarlatzis

Fertility and Sterility® Vol. 94, No. 1, June 2010

Objective: To investigate the effect of two different laparoscopic methods on ovarian reserve in patients with ovar-ian endometriomas.
Design: Prospective, randomized clinical trial.
Setting: Endoscopy unit of a university hospital.
Patient(s): Twenty women with endometriomas.
Intervention(s): Patients were randomly selected to undergo either laparoscopic cystectomy for endometrioma (group 1) or the ‘‘three-step procedure’’ (group 2). Before and 6 months after laparoscopy all patients were eval-uated, and 12 months postoperatively they underwent ultrasound scan examination.
Main Outcome Measure(s): The primary end point was ovarian reserve damage based on the alterations of anti-M€ullerian hormone (AMH). Secondary end points were the changes of antral follicle count and serum concentra-tion of FSH, LH, E2, and inhibin B.
Result(s): Mean serum AMH was reduced significantly from 3.9–2.9 ng/mL in group 1 compared with the reduc-tion from 4.5–3.99 ng/mL in group 2.
Conclusion(s): Ovarian reserve determined by AMH is less diminished after the three-step procedure compared with cystectomy of endometriomas. (Fertil Steril® 2010;94:71–7. Copywright 2010 by American Society for Reproductive Medicine.)
Key Words: Endometrioma, laporoscopic stripping, laparoscopic laser vaporization, ovarian reserve, anti-Müllerian hormone


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