The Optimal Time of Ovarian Reserve Recovery After Laparoscopic Unilateral Ovarian Non-Endometriotic Cystectomy

Frontiers in Endocrinology

Huaping Li¹  Yahong Liu¹  Xiaohong Ni²  Yanli Wang³  Bin Yan⁴  Ping Li⁵  Zhou Liu⁵  Zhiming Shu⁶  Ying Wang⁷ 

[1] Health Sciences Affiliated Zhoupu Hospital, Shanghai, China;Health Sciences, Shanghai, China;Department of Obstetrics and Gynecology, Ren Ji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China;Department of Obstetrics and Gynecology, Shanghai Punan Hospital, Shanghai, China;;Department of Obstetrics and Gynecology, Shanghai University of Medicine &Department of Obstetrics and Gynecology, The First People’s Hospital of Zhengzhou, Zhengzhou, China;;Shanghai University of Medicine &

关键词: ovarian reserve;    unilateral ovarian non-endometriotic cyst;    laparoscopic cystectomy;    fertility;    optimal time;   

DOI  :  10.3389/fendo.2021.671225

来源: DOAJ

【 摘 要 】

BackgroundLaparoscopic ovarian cystectomy is established as the standard surgical approach for the treatment of benign ovarian cysts. However, previous studies have shown that potential fertility can be directly impaired by laparoscopic ovarian cystectomy, diminished ovarian reserve (DOR), and even premature ovarian failure. Therefore, fertility-preserving interventions are required for benign gynecologic diseases. However, there are still little data on the time period required for recovery of ovarian reserve after the laparoscopic unilateral ovarian cystectomy, which is very important for the individualization of treatment protocols. This study aimed at investigating the time needed for the ovarian reserve to recover after laparoscopic unilateral ovarian non-endometriotic cystectomy.Materials and MethodsSixty-seven patients with unilateral ovarian non-endometriotic cyst from Zhoupu and Punan Hospitals who underwent laparoscopic unilateral ovarian cystectomy were recruited as a postoperative observation group (POG). Also, 69 healthy age-matched women without ovarian cyst who did not undergo surgery were recruited as a referent group (RFG). Ovarian reserve with the serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E2) levels, ovarian arterial resistance index (OARI), and antral follicle counts (AFCs) were measured on the third to fifth days of the same menstrual cycle. A postoperative 6-month follow-up of cases was performed.ResultsCompared with RFG, AFC of cyst side in the POG group showed no difference in the first, third, and sixth postoperative month (F = 0.03, F = 0.02, F = 0.55, respectively; p = 0.873, p = 0.878, p = 0.460, respectively). The OARI of cyst side in the POG group revealed no differences in the first, third, and sixth postoperative month (F = 0.73, F = 3.57, F = 1.75, respectively; p = 0.395, p = 0.061, p = 0.701, respectively). In the first month, the postoperative AMH levels significantly declined, reaching 1.88 ng/ml [interquartile range (IQR): 1.61–2.16 ng/ml] in POG and 2.57 ng/ml (IQR: 2.32–2.83 ng/ml) in RFG (F = 13.43, p = 0.000). For the data of AMH levels stratified by age, the same trend was observed between less than 25 and more than 26 years old. At this same time interval, the postoperative rate of decline was significantly lower compared to the preoperative one in POG (32.75%). The same trend was observed between the POG and RFG groups (26.67%).ConclusionsThe optimal time for recovery of ovarian reserve after laparoscopic unilateral ovarian cystectomy is estimated to be 6 months.

【 授权许可】

Unknown