Ovarian reserve after three‐step laparoscopic surgery for endometriomas utilizing dienogest: A pilot study

Reproductive Medicine and Biology

Kiyonori Miura¹  Michio Kitajima¹  Hideaki Masuzaki¹  Ayumi Harada²  Naoko Murakami²  Yuriko Kitajima²  Kanako Matsumoto² 

[1] Department of Obstetrics and Gynecology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan;Department of Obstetrics and Gynecology Nagasaki University Hospital Nagasaki Japan;

关键词: AMH;    dienogest;    endometrioma;    laparoscopic three‐step management;    ovarian reserve;   

DOI  :  10.1002/rmb2.12349

来源: DOAJ

【 摘 要 】

Abstract Purpose Surgery for endometriomas may cause detrimental effects on ovarian reserve. We evaluated the safety of three‐step laparoscopic surgery for endometriomas utilizing dienogest in terms of post‐surgical ovarian reserve. Methods Twelve women received first look laparoscopy (FLL) with fenestration and drainage. Immediately after the surgery, they took oral dienogest 2 mg for three months; then, they received second look laparoscopy (SLL) with cystectomy. We compared serum AMH levels between women had three‐step management with dienogest, and another twelve women had conventional one‐step surgery without medications. In women had three‐step procedures, the changes in concentration of proinflammatory cytokines and chemokines in peritoneal fluids were evaluated. Results Serum AMH levels were significantly decreased after three months of dienogest following FLL. AMH levels were also significantly decreased 3‐6 months both after SLL and after one‐step surgery; however, recovery of serum AMH levels at 9‐12 months after surgery was evident in women had three‐step surgery comparing to those of one‐step surgery. Proinflammatory cytokines and chemokines in peritoneal fluids were downregulated at the time of SLL comparing to those of FLL. Conclusions Three‐step surgery with dienogest may be a beneficial approach to protect ovarian reserve. Dienogest may exert its effects in part by lowering proinflammatory cytokines and chemokines.

【 授权许可】

Unknown