Endometriosis Center, Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Int J Gynaecol Obstet. 2024 May;165(2):696-702. doi: 10.1002/ijgo.15310. Epub 2023 Dec 20.
Endometriosis affects up to 10% of reproductive age women and is associated with pelvic pain and subfertility. While previous studies have shown an association between deep and ovarian endometriosis to reduced ovarian reserve, there is no data on the effect of superficial endometriosis on ovarian reserve markers. Hence, we aimed to compare ovarian reserve markers of women with superficial endometriosis to that of women without endometriosis.
This was a case control study in a tertiary medical center. The study group included women aged 18-40 with surgically and histopathology-proven superficial endometriosis with no deep lesions or ovarian involvement. The control group included women with no known or suspected endometriosis and was matched to the study group by age, BMI and parity. We excluded women with other known risk factors for ovarian failure and with other gynecological disorders. Participants completed a questionnaire with demographic, medical and gynecological data. Each patient underwent anti-Mullerian hormone (AMH) testing and an ultrasound to assess their antral follicular count (AFC). AMH and AFC were then compared between groups.
A total of 124 women participated in the study. Of these, 50% (n = 62) had surgically proven superficial endometriosis and 50% (n = 62) were without known or suspected endometriosis. Mean AMH levels of women with and without superficial endometriosis was 3.0 ± 2.8 ng/mL and 2.8 ± 1.9 ng/mL, respectively (P = 0.71). AFC also did not differ between groups (women with superficial endometriosis: 12.0 ± 6.6; women without endometriosis: 10.2 ± 5.0, P = 0.15).
In our cohort, superficial endometriosis was not associated with diminished ovarian reserve. While further studies are needed, to date, it does not appear to be justified to assess ovarian reserve for patients with superficial endometriosis.
子宫内膜异位症影响多达 10%的育龄妇女,与盆腔疼痛和不孕有关。虽然之前的研究表明深部和卵巢子宫内膜异位症与卵巢储备减少有关,但目前尚没有关于浅表子宫内膜异位症对卵巢储备标志物影响的数据。因此,我们旨在比较浅表子宫内膜异位症患者与无子宫内膜异位症患者的卵巢储备标志物。
这是一项在三级医疗中心进行的病例对照研究。研究组纳入了年龄在 18-40 岁之间的、经手术和组织病理学证实患有浅表子宫内膜异位症且无深部病变或卵巢受累的女性。对照组纳入了无已知或疑似子宫内膜异位症且与研究组年龄、BMI 和产次相匹配的女性。我们排除了有其他已知卵巢衰竭危险因素和其他妇科疾病的女性。所有参与者均完成了一份包含人口统计学、医疗和妇科数据的问卷。每位患者均接受了抗苗勒管激素(AMH)检测和超声检查以评估其窦卵泡计数(AFC)。然后比较两组之间的 AMH 和 AFC。
共有 124 名女性参与了这项研究。其中,50%(n=62)患有经手术证实的浅表子宫内膜异位症,50%(n=62)无已知或疑似子宫内膜异位症。有和无浅表子宫内膜异位症的女性的平均 AMH 水平分别为 3.0±2.8ng/ml 和 2.8±1.9ng/ml(P=0.71)。两组的 AFC 也没有差异(有浅表子宫内膜异位症的女性:12.0±6.6;无子宫内膜异位症的女性:10.2±5.0,P=0.15)。
在我们的队列中,浅表子宫内膜异位症与卵巢储备减少无关。虽然还需要进一步的研究,但到目前为止,似乎没有理由对浅表子宫内膜异位症患者进行卵巢储备评估。