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A prospective cohort study on laparoscopic cystectomy of endometrioma and its effects on ovarian reserve.

OBJECTIVE
To study the effects of laparoscopic surgical resection of ovarian endometrioma on ovarian reserve.


METHODS
The prospective cohort study was conducted from March 2014 to March 2019 at private clinics and hospitals in the Kerbala province of Iraq, and comprised women aged 19-42 years complaining of chronic pelvic pain, dysmenorrhea and dyspareunia. The measurement of serum anti-Müllerian hormone and follicular stimulating hormone was done preoperatively on the third day of the menstrual cycle. The levels were compared to those at 1 week and then 3 months postoperatively. Data was analysed using SPSS 20.


RESULTS
Of the 332 women with a mean age of 31.36±6.28 years, 9(2.7%) had minimal endometriosis, 23(6.9%) mild, 120(36.1%) moderate and 180(54.2%) had severe endometriosis. There was a significant decrease in serum anti-Müllerian hormone level and increase in follicular stimulating hormone level 1 week postoperatively (p<0.0001) and also at 3 months postoperatively (p<0.0001) compared to the baseline. There was a significant difference between the two cut-off points for both the markers (p≤0.001) postoperatively.


CONCLUSIONS
Laparoscopic resection of ovarian endometrioma led to decrease in serum anti-Müllerian hormone level at one week postoperatively then there was gradual increase 3 months postoperatively. The increment serum follicular stimulating hormone level continued even three months postoperatively.