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卵巢子宫内膜异位囊肿的手术切除:它真的会损害卵巢储备功能吗?手术后抗苗勒管激素(AMH)的长期变化。

Surgical excision of ovarian endometriomas: Does it truly impair ovarian reserve? Long term anti-Müllerian hormone (AMH) changes after surgery.

作者信息

Vignali Michele, Mabrouk Mohamed, Ciocca Erika, Alabiso Giulia, Barbasetti di Prun Allegra, Gentilini Davide, Busacca Mauro

机构信息

Department of Biomedical Science for the Health, University of Milan, Italy.

Gynecologic Oncology and Minimally Invasive Pelvic Surgery Unit, Sacred Heart Hospital, Verona, Italy.

出版信息

J Obstet Gynaecol Res. 2015 Nov;41(11):1773-8. doi: 10.1111/jog.12830. Epub 2015 Sep 30.

Abstract

AIM

The long-term effects of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral ovarian endometriomas were evaluated.

METHODS

A total of 22 patients undergoing laparoscopic cystectomy for unilateral endometrioma (n = 10) and bilateral endometriomas (n = 12) were included in the study.

RESULT(S): Serum anti-Müllerian hormone (AMH) levels significantly decreased from the baseline value (3.98 ± 3.27 ng/mL) one (1.67 ± 1.56 ng/mL), three (2.01 ± 1.70 ng/mL), and six months (2.43 ± 2.39 ng/mL) postoperatively. There was no difference between preoperative and 12 month postoperative AMH levels (4.01 ± 3.39 ng/mL) (P > 0.05). Patients with bilateral endometriomas had a significantly higher rate of decline in AMH levels 12 months after surgery than patients with monolateral endometriomas (P = 0.035), but in both groups there was no difference in AMH levels at one and 12 months postoperatively (P > 0.05).

CONCLUSION(S): AMH levels temporarily decreased after laparoscopic cystectomy for ovarian endometriomas, with complete recovery of preoperative AMH values at 12 months postoperatively. This pattern was equal in patients with bilateral and unilateral ovarian involvement. Patients with bilateral cysts have higher rates of decline of AMH levels compared to patients with unilateral affection.

摘要

目的

评估腹腔镜囊肿切除术对单侧和双侧卵巢子宫内膜异位症患者卵巢储备功能的长期影响。

方法

本研究纳入了22例行腹腔镜囊肿切除术治疗单侧子宫内膜异位症(n = 10)和双侧子宫内膜异位症(n = 12)的患者。

结果

术后1个月(1.67±1.56 ng/mL)、3个月(2.01±1.70 ng/mL)和6个月(2.43±2.39 ng/mL)时,血清抗苗勒管激素(AMH)水平较基线值(3.98±3.27 ng/mL)显著降低。术前与术后12个月的AMH水平(4.01±3.39 ng/mL)无差异(P>0.05)。双侧子宫内膜异位症患者术后12个月时AMH水平下降率显著高于单侧子宫内膜异位症患者(P = 0.035),但两组术后1个月和12个月时的AMH水平均无差异(P>0.05)。

结论

腹腔镜囊肿切除术后卵巢子宫内膜异位症患者的AMH水平暂时降低,术后12个月时术前AMH值完全恢复。双侧和单侧卵巢受累患者的这种模式相同。与单侧受累患者相比,双侧囊肿患者的AMH水平下降率更高。

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