The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study

ObjectiveTo investigate the effect of two different laparoscopic methods on ovarian reserve in patients with ovarian endometriomas.DesignProspective, randomized clinical trial.SettingEndoscopy unit of a university hospital.Patient(s)Twenty women with endometriomas.Intervention(s)Patients were randomly selected to undergo either laparoscopic cystectomy for endometrioma (group 1) or the “three-step procedure” (group 2). Before and 6 months after laparoscopy all patients were evaluated, and 12 months postoperatively they underwent ultrasound scan examination.Main Outcome Measure(s)The primary end point was ovarian reserve damage based on the alterations of anti-Müllerian hormone (AMH). Secondary end points were the changes of antral follicle count and serum concentration of FSH, LH, E2, and inhibin B.Result(s)Mean serum AMH was reduced significantly from 3.9–2.9 ng/mL in group 1 compared with the reduction from 4.5–3.99 ng/mL in group 2.Conclusion(s)Ovarian reserve determined by AMH is less diminished after the three-step procedure compared with cystectomy of endometriomas.