The Impact of Excision of Ovarian Endometrioma on Ovarian Reserve: A Systematic Review and Meta-Analysis

Francesca Raffi, Mostafa Metwally, Saad Amer
The Journal of clinical endocrinology and metabolism · 2012 · vol. 97(9) , pp. 3146–3154 · doi:10.1210/jc.2012-1558 · PMID:22723324 · W2088967422
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This meta-analysis found that surgical excision of ovarian endometriomas significantly decreases serum anti-müllerian hormone (AMH) levels, indicating a negative impact on ovarian reserve.

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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.

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Condition tags

mesh:D004715endometrioma

MeSH descriptors

Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Ovary Adolescent Adult Anti-Mullerian Hormone Anti-Mullerian Hormone Cell Count Cohort Studies Data Interpretation, Statistical Endometrial Neoplasms Endometriosis Female Follow-Up Studies Gonadal Steroid Hormones Gonadal Steroid Hormones Humans Laparoscopy

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References (52)

Cited by (50)

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