Muzii Ludovico, Luciano Anthony A, Zupi Errico, Panici Pierluigi Benedetti
Department of Obstetrics and Gynecology, "Sapienza" University, Rome, Italy.
Center for Fertility and Women's Health, University of Connecticut School of Medicine, New Britain, Connecticut.
J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):531-3. doi: 10.1016/j.jmig.2014.03.022. Epub 2014 Apr 12.
Recent evidence in the literature suggests that surgical excision of the endometrioma wall may reduce ovarian reserve, which may have a negative effect on subsequent reproductive function. However, because of inconsistent results and methodologic flaws of anti-müllerian hormone (AMH) as a marker of ovarian reserve, antral follicle count may be a more accurate noninvasive marker than AMH. Evaluating ovarian reserve using antral follicle count rather than AMH may yield different conclusions insofar as postsurgical damage to the ovary. Surgery should be performed only by experienced surgeons, and the stripping technique currently is still the only one supported by strong scientific evidence. The dual function of surgery, that is, to improve fertility and reduce pain, cannot be minimized or undervalued.
文献中的最新证据表明，子宫内膜异位囊肿壁的手术切除可能会降低卵巢储备，这可能会对后续的生殖功能产生负面影响。然而，由于抗苗勒管激素（AMH）作为卵巢储备标志物的结果不一致且存在方法学缺陷，窦卵泡计数可能是比AMH更准确的非侵入性标志物。就卵巢术后损伤而言，使用窦卵泡计数而非AMH评估卵巢储备可能会得出不同的结论。手术应由经验丰富的外科医生进行，目前剥除术仍然是唯一有强有力科学证据支持的方法。手术的双重功能，即提高生育能力和减轻疼痛，不能被忽视或低估。
