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Surgical treatment of endometriomas and ovarian reserve


Authors: D. Barátová 1;  L. Mekiňová 2 ;  K. Slabá 2;  I. Crha 2
Authors place of work: Gynekologicko-porodnické oddělení nemocnice, Kyjov, vedoucí pracoviště prim. MUDr. J. Maruška 1;  Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA 2
Published in the journal: Ceska Gynekol 2016; 81(3): 182-185

Summary

Objective:
To present an overview of affect an ovarian reserve in women after laparoscopic surgery for ovarian endometriosis.

Subject:
Review.

Setting:
Department of Obstetric and Gynecology, Hospital Kyjov; Department of Obstetric and Gynecology, University Hospital, Brno.

Methods:
Summary of the results of recent studies.

Results:
The decrease in ovarian reserve has been detected in 8 of 9 evaluated studies, specifically in one retrospective study, six prospective studies and in one systematic review, the results of the meta-analysis don´t prove the reduction of ovarian reserve after the surgery for endometrioma, reduced ovarian reserve evaluated by the antral follicle count has been proven in the affect ovary before the surgery.

Conclusion:
Endometriosis is among the most frequent benign gynecological diseases, affecting the women in reproductive age. Laparoscopic surgery techniques are currently the method of choice in the treatment of endometriotic ovarian cysts. Excision of endometriotic cyst is associated with significant reduction in ovarian reserve. The women with previous surgery of endometrioma have significantly fewer mature oocytes capable of fertilization, the ovarian response to stimulation is reduced and the number of live births is lower.

Keywords:
ovarian endometrioma, ovarian reserve, antral follicle count, anti-Müllerian hormone, laparoscopy


Zdroje

1. Alborzi, S., Keramati, P., Younesi, M., et al. The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas. Fertil Steril, 2014, 101(2), p. 427–434.

2. Biacchiardi, CP., Piane, LD., Camanni, M., et al. Laparoscopic stripping of endometriomas negatively affects ovarian follicular reserve even if performed by experienced surgeons. Reprod BioMed Online, 2011, 23, p. 740–746.

3. Hudeček, R., Ventruba, P., Unzeitig, V., et al. Analysis of ovarian hyperstimulation syndrome development using data mining. Scripta Medica, 2005, 78(6), p. 329–340.

4. Liao, T., Chang, C., Chiang, C., et al. Assessing ovarian reserve in woman after laparoscopic surgery for ovarian endometriosis. Taiwanese J Obstet Gynecol, 2004, 43(3), p. 144–148.

5. Missmer, SA., Cramer, DW. The epidemiology of endometriosis. Obstet Gynecol Clin North Am, 2003, 30(1), p. 1–19.

6. Muzii, L., Di Tucci, C., Di Feliciantonio, M., et al. The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count. Hum Reprod, 2014, 29(10), p. 2190–2198.

7. Shahla, K., Al-Alaf, Talha, Al-Shawaf, Namir, G. Al-Tawil. Ovarian reserve markers and assisted reproductive technique (ART) outcomes in women with advanced endometriosis. Reprod Biol Endocrin, 2014, 12:120.doi: 10.1186/1477-7827-12-120.

8. Sills, ES., Alper, MM., Walsh, AP. Ovarian reserve screening in infertility: practical applications and theoretical directions for research. Eur J Obstet Gynecol Reprod Biol, 2009, 149, p. 30–36.

9. Somigliana, E., Ragni, G., Benedetti, F., et al. Does laparoscopic excision of endometriotic ovarian cysts significantly affect ovarian reserve? Insights from IVF cycles. Hum Reprod, 2003, 18(11), p. 2450–2453.

10. Somigliana, E., Berlanda, N., Benaglia, L., et al. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertil Steril, 2012, 98(6), p. 1531–1538.

11. Urman, B., Alper, E., Yakin, K., et al. Removal of unilateral endometriomas is associated with immediate and sustained reduction in ovarian reserve, Reprod BioMed Online, 2013, 27, p. 212–216.

12. Var, T., Batioglu, S., Tonguc, E., Kahyaoglu, I. The effect of laparoscopic ovarian cystectomy versus coagulation in bilateral endometriomas on ovarian reserve as determinated by antral follicle count and ovarian volume. Fertil Steril, 2011, 95(7), p. 2247–2250.

Štítky
Dětská gynekologie Gynekologie a porodnictví Reprodukční medicína

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Česká gynekologie

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