Abstract: Background: Endometriosis could be present among women without any symptoms, accounting for as many as fifty percent of women seeking infertility treatment.Antral follicle count (AFC) as well as serum anti-Mullerian hormone (AMH) levels are often utilized as accurate quantitative ovarian reserve indicators. This work was aimed at assessing different endometrioma surgical treatment modalities’ impact on ovarian reserve.
Methods: Our prospective comparative study involved 40 cases whose ages fall between 20 and 35 years, female patients who are married, nullipara with unilateral endometrioma > 4 cm. Subject underwent a random equal allocation into two equal groups according to patient's condition intra-operative, hence decision of the operator: Group A (n=20): treated by laparoscopic excision of endometrioma and Group B (n=20): treated laparoscopically by evacuation of the cyst then by cyst wall’s cauterization utilizing Bipolar Diathermy.
Results: A significantly variance among AMH levels was documented within group A as well as between AFC in group A and B and AMH in group B during various follow-up periods (p<0.05). AMH within group A during various follow-up periods was significantly different between base line and after 6 months (P2 < 0.05). There was a significantly difference between base line with after 6 months, between base line with after 3 months and between 3 months with 6 months (P1, P2, P3 < 0.05) regarding of AFC within group A as well as AMH within group B during various follow-up periods. Pregnancy rate exhibited significant variances amongboth groups (p<0.05).
Conclusions: Both techniques, complete laparoscopic cystectomy and partial cystectomy with bipolar coagulation of the cyst wall have adverse effect as regards ovarian reserve determined with serum AMH level. However, AFC increased after both techniques. No significant variance was documented among both groups as regards the ovarian reserve’s degree of reduction.
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