Department of Health of Woman and Child, University of Padua, Padua, Italy.
Gynecol Endocrinol. 2013 May;29(5):452-4. doi: 10.3109/09513590.2012.758704. Epub 2013 Jan 31.
Operative laparoscopy is the gold standard in the treatment of endometriotic ovarian cysts. Excisional surgery is the best technique to prevent recurrences and improve symptoms but it may result in ovarian reserve damage due to the removal of healthy ovarian cortex. The aim of this study was to investigate the extent of the ovarian reserve damage after stripping technique of unilateral endometriomas, by dosing the Anti-Müllerian Hormone (AMH). This prospective study was conducted at the Center of Minimally Invasive Pelvic Surgery of the Department of Health of Woman and Child, University of Padua, from October 2010 to June 2012. Twenty-five women underwent excision of monolateral endometriosis ovarian cyst by stripping without accessing a bipolar coagulation and performing an intracortical suture. The AMH serum levels were estimated in the early proliferative phase of the cycle, before surgery (time 0), 24 h after surgery (time 1), the first menstrual cycle after surgery (time 2) and the third menstrual cycle after surgery (time 3). We found a nonstatistically significant decreases in serum AMH levels after surgical excision of the cysts. Our results suggest that an appropriate surgical technique, without the use of the bipolar coagulation of ovarian border, does not determine a significant reduction of ovarian reserve.
手术腹腔镜是治疗子宫内膜异位症卵巢囊肿的金标准。切除手术是预防复发和改善症状的最佳技术,但由于去除健康的卵巢皮质,可能会导致卵巢储备功能受损。本研究旨在通过检测抗苗勒管激素 (AMH) 来探讨单侧子宫内膜异位症囊肿剥除术后卵巢储备功能受损的程度。这项前瞻性研究于 2010 年 10 月至 2012 年 6 月在帕多瓦大学妇女儿童健康系微创骨盆手术中心进行。25 名妇女接受了单侧子宫内膜异位症囊肿的切除手术,术中不使用双极电凝,也不进行皮质内缝合。在手术前(时间 0)、手术后 24 小时(时间 1)、手术后第一个月经周期(时间 2)和手术后第三个月经周期(时间 3),估计 AMH 血清水平。我们发现,在手术切除囊肿后,血清 AMH 水平呈非统计学意义的下降。我们的结果表明,适当的手术技术,不使用卵巢边缘的双极电凝,不会导致卵巢储备功能显著降低。