Turkcuoglu Ilgın, Melekoglu Rauf
a Department of Obstetrics and Gynecology, Faculty of Medicine , The University of Inonu , Malatya , Turkey.
Gynecol Endocrinol. 2018 Jul;34(7):612-615. doi: 10.1080/09513590.2017.1419174. Epub 2017 Dec 19.
The objective of this study was to evaluate the long-term effects of endometrioma excision on ovarian reserve. This study evaluated the long-term effects of endometrioma excision on ovarian reserve. A total of 63 women were enrolled in this prospective case-control study; 21 women had histories of endometrioma surgery (study group), 21 women had diagnoses of endometrioma, and 21 healthy age-matched women served as controls. Participants were recruited from the Department of Obstetrics and Gynecology, Inonu University Faculty of Medicine, between January 2007 and January 2016. The mean follow-up duration after endometrioma surgery was 30.4 ± 18.0 months for the study group. The mean follicle-stimulating hormone, luteinizing hormone and estradiol levels were similar among groups, but the anti-Müllerian hormone (AMH) level was significantly lower in the surgery group than in the control group (p < .001). The mean AMH level was 42% lower in the endometrioma surgery group than in the endometrioma group and 30% lower in the endometrioma group than in the control group (p = .080 and p = .160, respectively). Endometrioma has a detrimental effect on ovarian reserve, and decreased ovarian reserve compared with that in healthy fertile subjects without endometrioma is evident shortly after endometrioma excision. However, the endometrioma excision procedure does not significantly decrease the ovarian reserve in the long term.
本研究的目的是评估子宫内膜异位囊肿切除术对卵巢储备功能的长期影响。本研究评估了子宫内膜异位囊肿切除术对卵巢储备功能的长期影响。共有63名女性纳入了这项前瞻性病例对照研究;21名女性有子宫内膜异位囊肿手术史(研究组),21名女性被诊断为子宫内膜异位囊肿,21名年龄匹配的健康女性作为对照组。参与者于2007年1月至2016年1月期间从伊诺努大学医学院妇产科招募。研究组子宫内膜异位囊肿手术后的平均随访时间为30.4±18.0个月。各组间促卵泡生成素、促黄体生成素和雌二醇水平相似,但手术组抗苗勒管激素(AMH)水平显著低于对照组(p<0.001)。子宫内膜异位囊肿手术组的平均AMH水平比子宫内膜异位囊肿组低42%,子宫内膜异位囊肿组比对照组低30%(分别为p=0.080和p=0.160)。子宫内膜异位囊肿对卵巢储备功能有不利影响,与无子宫内膜异位囊肿的健康可育受试者相比,子宫内膜异位囊肿切除术后不久卵巢储备功能下降明显。然而,从长期来看,子宫内膜异位囊肿切除手术不会显著降低卵巢储备功能。