Salihoğlu Kerime N, Dilbaz Berna, Cırık Derya Akdağ, Ozelci Runa, Ozkaya Enis, Mollamahmutoğlu Leyla
Department of Reproductive Medicine and Infertility, Etlik Zubeyde Hanim Womens' Health Training and Teaching Hospital, Ankara, Turkey.
Department of Reproductive Medicine and Infertility, Etlik Zubeyde Hanim Womens' Health Training and Teaching Hospital, Ankara, Turkey.
J Minim Invasive Gynecol. 2016 Jul-Aug;23(5):719-25. doi: 10.1016/j.jmig.2016.02.018. Epub 2016 Mar 3.
To evaluate the short-term changes in ovarian reserve markers after laparoscopic cystectomy performed for endometriotic and nonendometriotic cysts.
Prospective case-control study (Canadian Task Force classification II-2).
The Reproductive Endocrinology Clinic of a training and research hospital.
Thirty-four women with endometrioma ≥ 4 mm (group 1) and 33 women with nonendometriotic cysts of matched size (group 2) who underwent surgery during the same period.
The follicular phase follicle-stimulating hormone (FSH), estradiol (E2), and antimüllerian hormone (AMH) levels and the antral follicle count (AFC) of both groups were analyzed preoperatively and 2 months after laparoscopic cystectomy. The pre- and postoperative values were compared within the same group and between the 2 groups.
Preoperative FSH and E2 levels were similar in both groups. However, preoperative AMH levels and AFC were significantly lower in group 1 (endometrioma) compared with group 2 (nonendometrioma; p = .004 and p = .025, respectively). In both groups there was a significant decrease in the AMH levels after surgery (3.1 ± 1.9 ng/mL to 2.5 ± 1.6 ng/mL, p < .001, and 5.7 ± 3.7 ng/mL to 4.8 ± 3.3 ng/mL, p = .04). AMH levels exhibited a significant decrease in the unilateral and bilateral endometrioma groups after cystectomy (p < .001 and p = .025, respectively). However, preoperative and postoperative changes in AMH and AFC were similar in groups 1 and 2 for both unilateral and bilateral cysts (p = .586 and p = .267).
Preoperative AMH and AFC levels are lower in both unilateral and bilateral endometriomas compared with nonendometriotic cysts. The AMH levels decreased after cystectomy in both endometriotic and nonendometriotic cysts. However, in the short-term period the amount of change in ovarian reserve tests in both unilateral and bilateral cysts was similar for both endometrioma and nonendometriotic cysts.
评估因子宫内膜异位囊肿和非子宫内膜异位囊肿行腹腔镜囊肿切除术后卵巢储备指标的短期变化。
前瞻性病例对照研究（加拿大工作组分类II-2）。
一家培训和研究医院的生殖内分泌诊所。
34例子宫内膜瘤≥4mm的女性（第1组）和33例同期接受手术的大小匹配的非子宫内膜异位囊肿女性（第2组）。
分析两组患者术前及腹腔镜囊肿切除术后2个月的卵泡期促卵泡激素（FSH）、雌二醇（E2）、抗苗勒管激素（AMH）水平及窦卵泡计数（AFC）。比较同一组内及两组间术前和术后的值。
两组术前FSH和E2水平相似。然而，与第2组（非子宫内膜瘤）相比，第1组（子宫内膜瘤）术前AMH水平和AFC显著降低（分别为p = 0.004和 p = 0.025）。两组术后AMH水平均显著下降（3.1±1.9ng/mL降至2.5±1.6ng/mL，p < 0.001；5.7±3.7ng/mL降至4.8±3.3ng/mL，p = 0.04）。囊肿切除术后，单侧和双侧子宫内膜瘤组的AMH水平均显著下降（分别为p < 0.001和p = 0.025）。然而，对于单侧和双侧囊肿，第1组和第2组术前和术后AMH及AFC的变化相似（p = 0.586和p = 0.267）。
与非子宫内膜异位囊肿相比，单侧和双侧子宫内膜瘤术前的AMH水平和AFC均较低。子宫内膜异位囊肿和非子宫内膜异位囊肿切除术后AMH水平均下降。然而，短期内，单侧和双侧囊肿中，子宫内膜瘤和非子宫内膜异位囊肿的卵巢储备检测变化量相似。
