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Comparative Study
. 2015 Sep 10:15:74.
doi: 10.1186/s12905-015-0230-1.

The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis

Hsin-Ju Chiang  1 , Pin-Yao Lin  2 , Fu-Jen Huang  3 , Fu-Tsai Kung  4 , Yu-Ju Lin  5 , Pei-Hsun Sung  6 , Kuo-Chung Lan  7
Affiliations
Comparative Study

The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis

Hsin-Ju Chiang et al. BMC Womens Health. .

Abstract

Background: To investigate the impact of previous ovarian surgery on ovarian reserve in patients with endometriosis.

Methods: A total of 829 female patients were recruited. Their medical records were reviewed retrospectively. Patients who had diagnoses of endometriosis or endometrioma were defined as the endometriosis group, and those without endometriosis were as the control group. We further divided these patients into four groups according to whether they had received ovarian surgeries before. Group 1: control group without previous surgery; Group 2: control group with previous surgery; Group 3: endometriosis group without previous surgery; Group 4: endometriosis group with previous surgery. The subgroups with endometrioma or not and different operative procedures were also analyzed. The parameters for comparison included age, body mass index, serum estradiol, follicle-stimulating hormone, luteinizing hormone, cancer antigen 125, and anti-Müllerian hormone (AMH) level.

Results: The level of serum AMH was highest in group 1 and lowest in group 4. The decline was significant between group 1 and group 4 (p < 0.05). The serum AMH level was lower in group 4 than in group 3 but no significant difference. Serum estradiol level was significantly higher in group 3 than in group 2 (p < 0.05). Cancer antigen 125 levels were both significantly higher in group 3 and group 4 as compared with group 1 and group 2 (p < 0.05).

Conclusions: Performing repeated ovarian surgery in patients with recurrent endometriosis needs careful consideration and adequate patient counselling because of the predictable deteriorating ovarian reserve.

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Figures

Fig. 1
Fig. 1
Patients enrollment flowchart
Fig. 2
Fig. 2
Parameters for comparison among 4 groups. (a) age (b) BMI: body mass index, (c) E2: serum estradiol, (d) FSH: follicle-stimulating hormone, (e) LH: luteinizing hormone, (f) AMH: anti-Müllerian hormone, (g) CA-125: cancer antigen 125. *, § = statistical significance (p < 0.05)
See this image and copyright information in PMC

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