Relation of Endometrioma and Deep Infiltrating Endometriosis Surgery on Ovarian Reserve: A Large Single-Centre, Cross-Sectional Study
نویسندگان
1 Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
2 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
3 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Obstetrics and Gynecology, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
5 Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
6 Department of Obstetrics and Gynecology, Division of Laparoscopic Gynecology – Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
7 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
doi
10.22074/ijfs.2025.2034762.1723چکیده
Background: There is a lack of reliable data or evidence-based protocol for the management of deep infiltrating endometriosis(DIE) lesions in reproductive age women. This study examines ovarian reserves in women who underwentendometriosis surgeries in an attempt to assist clinicians with decision-making for surgery and fertility preservation.Materials and Methods: This single-centre cross-sectional study included 508 women who underwent laparoscopicendometriosis surgery from June 2018 to December 2022. The women were divided into three groups: endometrioma(OMA; n=156), OMA+DIE (n=235), and DIE (n=117). Their anti-Müllerian hormone (AMH) levels were comparedto 50 healthy controls before surgery and at four and eight months post-surgery.Results: The DIE group had lower baseline AMH levels compared to the other groups (P<0.0001) following surgery,AMH levels decreased notably across all groups (P<0.001). Reductions in AMH levels after surgery were as follows:OMA group (49.84%), OMA+DIE group (62.20%), and the DIE group (43.46%). The most substantial decline wasobserved in the OMA+DIE group. There was no significant difference in AMH levels between four and eight monthspost-surgery.Conclusion: Although the OMA+DIE group experienced the greatest drop in ovarian reserve after surgery, DIE is as effectiveas OMA in reducing ovarian reserve pre- and post-surgery. Hence, overlooked DIE lesions during an ultrasoundexamination can greatly impact ovarian reserve in these women.
