Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve

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dc.contributor.authorSeyhan, Ayşe
dc.contributor.buuauthorUncu, Gürkan
dc.contributor.buuauthorKasapoğlu, Işıl
dc.contributor.buuauthorÖzerkan, Kemal
dc.contributor.buuauthorYılmaztepe, Arzu Oral
dc.contributor.buuauthorAta, Barış
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.tr_TR
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.tr_TR
dc.contributor.orcid0000-0003-0463-6818tr_TR
dc.contributor.orcid0000-0003-1106-3747tr_TR
dc.contributor.researcheridAAT-3479-2021tr_TR
dc.contributor.researcheridA-5841-2017tr_TR
dc.contributor.researcheridAAH-9791-2021tr_TR
dc.contributor.scopusid6603716169tr_TR
dc.contributor.scopusid55800494800tr_TR
dc.contributor.scopusid6603345841tr_TR
dc.contributor.scopusid55801043100tr_TR
dc.contributor.scopusid16306205100tr_TR
dc.date.accessioned2022-11-10T06:45:07Z
dc.date.available2022-11-10T06:45:07Z
dc.date.issued2013-08
dc.description.abstractDo the presence of endometriomas and their laparoscopic excision lead to a decrease in ovarian reserve as assessed by serum anti-Mllerian hormone (AMH) levels? Both the presence and excision of endometriomas cause a significant decrease in serum AMH levels, which is sustained 6 months after surgery. No previous comparison of serum AMH levels between women with and without endometrioma has been reported. However, studies have suggested a decline in serum AMH levels 13 months after endometrioma excision but long-term data are needed. A prospective cohort study including 30 women with endometrioma 2 cm were age matched with 30 healthy women without ovarian cysts. Women with endometrioma underwent laparoscopic excision with the stripping technique. Serum AMH level and antral follicle count (AFC) were determined preoperatively, 1 and 6 months after surgery. Correlation analyses were undertaken in order to identify determinants of surgery-related change in ovarian reserve. Compared with controls at baseline, women with endometrioma had lower AMH levels (4.2 2.3 versus 2.8 2.2 ng/ml, respectively, P 0.02) and AFC (14.7 4.1 versus 9.7 4.8, respectively, P 0.01). Serum AMH levels were further decreased 6 months after surgery (2.8 2.2 versus 1.8 1.3 ng/ml, P 0.02), while AFC remained unchanged (9.7 4.8 versus 10.4 4.2, P 0.63). The rate of decline in AMH was not correlated with age, laterality of endometrioma, cyst diameter or the number of primordial follicles on the surgical specimens. The preoperative serum AMH level was positively correlated with the rate of decline in serum AMH after surgery (r 0.47, P 0.02). The absence of a non-treated group of women with endometriomas as a further control prevents comment on the presence of a progressive decline in ovarian reserve related to endometrioma per se. The sample size may be too small for detection of factors correlated with the extent of ovarian damage. While the findings are mostly in agreement with previous studies, the present study is the first to show that the presence of endometrioma per se is associated with a decrease in ovarian reserve. The extent of surgery-related decline in ovarian reserve is not predictable using preoperative or perioperative factors. It may be prudent to measure AMH levels preoperatively and delay/avoid surgical excision as far as is possible if subsequent fertility is a concern. Additional studies are required to further investigate whether the endometrioma-related decline in ovarian reserve per se is progressive in nature and whether it exceeds the surgery-related decline. This study was funded by the Research Fund of the Uludag University School of Medicine. The authors have no conflict of interest associated with this study.en_US
dc.identifier.citationUncu, G. vd. (2013). "Prospective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserve". Human Reproduction, 28(8), 2140-2145.en_US
dc.identifier.endpage2145tr_TR
dc.identifier.issn0268-1161
dc.identifier.issue8tr_TR
dc.identifier.pubmed23624580tr_TR
dc.identifier.scopus2-s2.0-84880518947tr_TR
dc.identifier.startpage2140tr_TR
dc.identifier.urihttps://doi.org/10.1093/humrep/det123
dc.identifier.urihttps://academic.oup.com/humrep/article/28/8/2140/659582
dc.identifier.urihttp://hdl.handle.net/11452/29445
dc.identifier.volume28tr_TR
dc.identifier.wos000322342200016tr_TR
dc.indexed.pubmedPubMeden_US
dc.indexed.scopusScopusen_US
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.bapUludağ Üniversitesitr_TR
dc.relation.collaborationSanayitr_TR
dc.relation.journalHuman Reproductionen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectObstetrics & gynecologyen_US
dc.subjectReproductive biologyen_US
dc.subjectEndometriosisen_US
dc.subjectAnti-Mllerian hormoneen_US
dc.subjectAntral follicle counten_US
dc.subjectOvarian reserveen_US
dc.subjectLaparoscopyen_US
dc.subjectAnti-mullerian hormoneen_US
dc.subjectAntimullerian hormoneen_US
dc.subjectDiagnosed endometriosisen_US
dc.subjectLaparoscopic excisionen_US
dc.subjectWomenen_US
dc.subject.emtreeMuellerian inhibiting factoren_US
dc.subject.emtreeAdulten_US
dc.subject.emtreeArticleen_US
dc.subject.emtreeCancer surgeryen_US
dc.subject.emtreeClinical articleen_US
dc.subject.emtreeCohort analysisen_US
dc.subject.emtreeControlled studyen_US
dc.subject.emtreeEndometrium tumoren_US
dc.subject.emtreeFemaleen_US
dc.subject.emtreeHormone blood levelen_US
dc.subject.emtreeHumanen_US
dc.subject.emtreeOvarian reserveen_US
dc.subject.emtreeOvary follicleen_US
dc.subject.emtreePreoperative perioden_US
dc.subject.emtreeProspective studyen_US
dc.subject.scopusDienogest; Ovarian Reserve; Elagolixen_US
dc.subject.wosObstetrics & gynecologyen_US
dc.subject.wosReproductive biologyen_US
dc.titleProspective assessment of the impact of endometriomas and their removal on ovarian reserve and determinants of the rate of decline in ovarian reserveen_US
dc.typeArticle
dc.wos.quartileQ1en_US

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