Surgery for endometriomas within the context of infertility treatment
European Journal of Obstetrics & Gynecology and Reproductive Biology Sep 29, 2019
Dubinskaya ED, et al. - In this prospective cohort study of infertility patients with unilateral endometrioma (3–5 s m in diameter) aged 25–35, researchers evaluated anti-Müllerian hormone (AMH) levels and spontaneous pregnancy rate depending on initial AMH levels and cyst type. Laparoscopic cystectomy was undertaken in all these patients. Type II endometriomas were observed in 70% vs 30% of patients with normal AMH level vs low AMH level, respectively. Patients with normal AMH level and type I endometriomas showed a significant decrease in AMH level at 1 month. But at 3 months, the AMH level comparable to initial parameters was observed. A significant decrease of AMH level at 1 and at 3 months after surgery was observed among women with low AMH levels before surgery and type I cysts. They observed best outcomes among all patients with a time interval of 6 months after surgery, with significantly higher pregnancy rate in patients with normal AMH level and type II cysts and with AMH less than 2 ng/ml and type I cysts. Data support that a good surgical technique may help to enhance the pregnancy rate in infertility patients with endometriomas. Infertility patients with normal AMH level and type II endometriomas comprised the good prognosis group.
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