Factors affected the ovarian reserve after laparoscopic cystectomy for ovarian endometriomas

Objective

To identify related factors that affect the ovarian reserve after laparoscopic ovarian cystectomy in patients with endometriomas.

Study design

It was a retrospective cohort study performed in a tertiary-care university hospital. A total of 409 patients with endometriomas underwent laparoscopic ovarian cystectomy between June 2014 and November 2021.

Results

The demographic and operative data, including age, parity, body mass index, tumor size, operating time, and estimated blood loss were recorded. Serum anti-Mullerian hormone (AMH) levels were recorded preoperatively, as well as 10 days (immediately) and 6 months after the procedure respectively. The decrease of serum AMH level at 6 months after the surgery were 0.7 ± 1.6 ng/mL (22.5 ± 57.1 %) in the unilateral group and 1.5 ± 2.1 ng/mL (48.3 ± 65.6 %) in the bilateral group. The reduction in the serum AMH level at 10 days and 6 months after the operation were significant compared to the baseline level. The bilateral group has a significantly lower serum AMH level than that of the unilateral group in terms of 10 days and 6 months after operation (p < 0.001). Baseline serum AMH level < 2 ng/mL have shown less reduction in both 10 days group and 6 months group with odds ratio (OR) 0.36 (p = 0.01) and OR 0.264 (p < 0.001) respectively. Neither patient’s age nor tumor size contributed to the decline of ovarian reserve.

Conclusions

Bilaterality and pre-operative serum AMH level are the two key factors that affect ovarian reserve after laparoscopic cystectomy.