Analysis of pregnancy outcome and decline of anti-Mullerian hormone after laparoscopic cystectomy for ovarian endometriomas

作者：Taniguchi Fuminori; Sakamoto Yasuko; Yabuta Yuko; Azuma Yukihiro; Hirakawa Eriko; Nagira Kei; Uegaki Takashi; Deura Imari; Hata Koukichi; Harada Tasuku

来源：Journal of Obstetrics and Gynaecology Research, 2016, 42(11): 1534-1540.

DOI：10.1111/jog.13081

• AMH
• cystectomy
• ovarian endometrioma

AimExcision of ovarian endometrioma (OE) may induce the reduction of ovarian reserve. We evaluated pregnancy outcomes after laparoscopic cystectomy (LC), and the pre- and postoperative levels of anti-Mullerian hormone (AMH) to consider the ovarian reserve.
MethodsWe enrolled 40 women with OE and 16 women with benign ovarian tumors who hoped to have a child and who underwent LC. To evaluate the ovarian reserve of 40 patients (OE group, n = 24; non-OE group, n = 16), we measured serum AMH levels before and after the surgery.
ResultsIn the 40 women who underwent LC for OE, the cumulative pregnancy rate was 50%. Prior to the cystectomy, serum AMH levels in the OE group, especially in patients over the age of 35, were significantly lower than those in the non-OE group. Rate of decline in serum AMH in the OE group was significant compared with that in the non-OE group 6 months after surgery. In patients over the age of 35 in the OE group, AMH levels 1 year after surgery decreased noticeably.
ConclusionLC for OE could be a preferred surgical approach, but effective therapeutic strategies will have to be developed to prevent damage to the ovarian reserve, especially for older patients.

• 出版日期2016-11