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J Clin Endocrinol Metab. 2012 Sep;97(9):3146-54. doi: 10.1210/jc.2012-1558. Epub 2012 Jun 20.

The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis.

Author information

1
University of Nottingham, Medical School, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3DT, United Kingdom. mzxfr1@nottingham.ac.uk

Abstract

CONTEXT:

Endometriomas are mainly treated surgically. However, there has been concern over the potential damaging effect of this surgery on ovarian reserve.

OBJECTIVE:

The aim of this meta-analysis was to investigate the impact of surgery for endometriomas on ovarian reserve as determined by serum anti-müllerian hormone (AMH).

DATA SOURCES:

MEDLINE, PubMed, and Embase were searched electronically.

STUDY SELECTION:

All prospective cohort studies that analyzed changes of serum AMH concentrations after surgical treatment of endometriomas were eligible. Twenty-one studies were identified, of which eight were selected for meta-analysis.

DATA EXTRACTION:

Two reviewers performed the data extraction independently.

DATA SYNTHESIS:

Pooled analysis of 237 patients showed a statistically significant decrease in serum AMH concentration after ovarian cystectomy (weighted mean difference -1.13 ng/ml; 95% confidence interval -0.37 to -1.88), although heterogeneity was high. Sensitivity analysis for studies with a preoperative serum AMH level of 3.1 ng/ml or greater improved heterogeneity but also still showed a significant postoperative fall in serum AMH (weighted mean difference -1.52 ng/ml, 95% confidence interval -1.04 to -2).

CONCLUSION:

The results of this study suggest a negative impact of excision of endometriomas on ovarian reserve as evidenced by a significant postoperative fall in circulating AMH.

PMID:
22723324
DOI:
10.1210/jc.2012-1558
[Indexed for MEDLINE]

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