Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst

¹Okan University School of Medicine, Department of Obstetrics and Gynecology
²İstanbul Medeniyet University School of Medicine, Department of Obstetrics and Gynecology

Objective: To compare the effects of laparoscopic cystectomy on ovarian reserve between women with endometrioma and dermoid cyst.
Materials and Methods: Thirty six patients were diagnosed with endometrioma (Group A) and 32 patients diagnosed with dermoid cyst (Group B) by ultrasonography. Preoperative anti-mullerian hormone (AMH) levels were measured and unilateral antral follicle count (AFC) was calculated for the ovary side containing the cyst. Laparoscopic cystectomy was performed by stripping technique for all participants. After 3 months, all participants were re-evaluated between the third and sixth day of their menstrual cycle to determine AFC and AMH levels.
Results: The mean serum preoperative AMH level and AFC level were significantly lower in group A than in group B [(p=0.001),(p=0.002)], respectively. At 3 months after the surgery, serum AMH levels decreased significantly in group A from 2.04±0.68 to 1.47±0.55 (p=0.001), in group B decreased from 2.60±0.57 to 2.17±0.56 (p=0.001). In group A, unilateral (operated side) AFC level decreased significantly from 4.05±1.24 to 2.16±0.94 (p=0.001), and in group B, it decreased significantly from 4.93±0.94 to 3.40±0.87 (p=0.001). The decrease in AMH levels was significantly higher in group A than in group B (p=0.033). The decrease in AFC levels was also significantly higher in group A than in group B (p=0.044).
Conclusion: Laparoscopic stripping technique has destructive effects on serum AMH levels and operated side AFC levels after surgery for both patients with endometrioma and dermoid cysts, and laparoscopic excision of endometrioma has more destructive effects on ovarian reserve than dermoid cysts.

Keywords:

Endometriomalı ve Dermoid Kistli Hastalarda Laparoskopik Kistektominin Ovaryan Rezerv Üstüne Etkisi

¹Okan Üniversitesi Hastanesi, Kadın Hastalıkları Ve Doğum Ana Bilim Dalı, İstanbul
²İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma hastanesi, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, İstanbul

Amaç: Laparoskopik kistektominin ovaryan rezerv üzerine etkisini endometriomalı ve dermoid kistli hastalarda karşılaştırmak.
Gereç ve Yöntemler: Ultrasonografik olarak preoperatif tanı konulmuş 36 endometriomalı (Grup A) ve 32 dermoid kistli (Grup B) hasta çalışmaya alındı. Preoperatif anti-mullerian hormon (AMH) ve kistin olduğu overdeki antral folikül sayıları (AFC) ölçüldü. Tüm hastalara laparoskopik kistektomi stripping tekniği uygulanarak yapıldı. Ameliyattan 3 ay sonra tüm hastaların AMH ve AFC ölçümleri siklusun 3. ve 6. günleri arası tekrar yapıldı.
Bulgular: Preoperatif serum AMH seviyeleri ve opere olan taraftaki AFC değerleri grup A da grup B de göre anlamlı derecede düşük saptandı [(p=0.001),(p=0.002)], sırasıyla. Ameliyattan 3 ay sonra serum AMH seviyesi grup A da 2.04±0.68’den 1.47±0.55’e (p=0.001), grup B de 2.60±0.57’den 2.17±0.56 ‘ya (p=0.001) düştü. AFC seviyesi grup A da ameliyattan 3 ay sonra 4.05±1.24’ten 2.16±0.94’e, grup B de 4.93±0.94’den 3.40±0.87’ye (p=0.001) düştü. AMH seviyesindeki düşüş grup A da grup B ye göre anlamlı derecede daha fazla olarak görüldü (p=0.033). AFC değerindeki düşüş grup A da grup B ye göre anlamlı oranda daha fazla idi (p=0.044).
Sonuç: Laparoskopik stripping tekniği hem endometriomalı hem de dermoid kistli hastalarda serum AMH ve opere olan taraftaki AFC seviyeleri üstünde yıkıcı etkilere sahip. Endometriomaların laparoskopik olarak çıkartılması ovaryan rezerv üzerine dermoid kistlere göre daha yıkıcı etkilere sahip.

Anahtar Kelimeler:

Cihan Karadağ, sinem demircan karadağ, Abdulkadir Turgut, Eray Caliskan. Effects of laparoscopic cystectomy on ovarian reserve in patients with endometrioma and dermoid cyst. . 2020; 17(1): 0-0

Corresponding Author: Cihan Karadağ, Türkiye