Abstract
Background
The presence of an endometrioma can often be accompanied by a clinical dilemma during
the course of fertility treatment. The aim of this study was to evaluate anti-Müllerian
hormone (AMH) levels and spontaneous pregnancy rate in infertility patients with endometriomas
depending of initial AMH levels and cyst type.
Methods
This prospective cohort study included infertility patients with unilateral endometrioma
(3–5 s m in diameter) aged 25–35. A total of them underwent laparoscopic cystectomy.
All patients were divided into two groups due to AMH levels and cyst type during surgery.
We investigated AMH levels and spontaneous pregnancy rate in 1,3 and 12 months after
surgery.
Results
The majority of patients with normal AMH level had type II endometriomas (70%) compared
with low AMH level group (30%). There were no significant differences between AMH
levels in all the patients with type II endometriomas after surgery. AMH level decreased
significantly at 1 month in patients with normal AMH level and type I endometriomas
(P = 0.018). But at 3 months the AMH level was compared with initial parameters. Women
with low AMH levels before surgery and type I cysts had a significant decrease of
AMH level at 1 and at 3 months after surgery. All patients with a time interval of
6 months after surgery had the best outcomes with significantly higher pregnancy rate
(PR) in patients with normal AMH level and type II cysts (P = 0.036) and with AMH
less than 2 ng/ml and type I cysts (P = 0.021). The group with normal AMH level and
type II endometriomas had a significantly higher ongoing cumulative PR than others
(59.4%).
Conclusions
Our data suggest that laparoscopic surgery could affect ovarian reserve in case of
initial low AMH levels and type I of endometriomas. We believe that the good surgical
technique helps to increase pregnancy rate in infertility patients with endometriomas.
Good prognosis group are the infertility patients with normal AMH level and type II
endometriomas.
Keywords
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Article info
Publication history
Published online: August 19, 2019
Accepted:
August 17,
2019
Received in revised form:
August 16,
2019
Received:
April 20,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
