AMH trend after laparoscopic cystectomy and ovarian suturing in patients with endometriomas
AMH trend after laparoscopic cystectomy and ovarian suturing in patients with endometriomas
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DOI：
10.1007/s00404-015-3926-4
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发表时间：
2016-05-01
影响因子：
2.6
通讯作者：
Xu, Xiao-Jiu
中科院分区：
文献类型：
--
作者：
Shao, Ming-Jun;Hu, Min;Xu, Xiao-Jiu
为探讨子宫内膜异位症患者腹腔镜手术后卵巢储备功能的变化，对80例单侧或双侧子宫内膜异位症患者行经腹腔镜行卵巢囊肿摘除术后缝线止血。双侧子宫内膜异位症患者于月经周期第3天、术后6个月和12个月测定血清抗髓鞘激素(AMH)和卵泡刺激素(FSH)水平，双侧子宫内膜异位症患者术后6个月(3.05+/-A1.99 ng/ml)和12个月(2.26+/-A1.88 ng/ml)血清AMH水平显著下降(P<0.05)，而FSH水平则显著升高(P<0.05)。单侧子宫内膜瘤患者术后6个月和12个月的AMH水平也较低。单侧和双侧子宫内膜异位症患者术后6个月和12个月的AMH下降和FSH升高的比率比较，差异有统计学意义(P<；0.05)。AMH和FSH值的变化表明，卵巢子宫内膜异位症摘除后，尽管采用缝合技术止血，但卵巢储备明显减少，尤其是双侧子宫内膜瘤患者。卵巢缝合对卵巢储备的保护作用可能是边际的。
To evaluate the ovarian reserve after laparoscopic cystectomy with suturing in patients with endometriomas.A total of 80 women with unilateral or bilateral endometriomas underwent laparoscopic cystectomy using sutures for hemostasis after the excision of ovarian cysts. Serum levels of antimullerian hormone (AMH) and FSH were measured at the day 3 of menstrual cycles preoperatively, 6 and 12 months postoperatively.In the bilateral endometrioma group, serum AMH level decreased significantly from the baseline (4.68 +/- A 2.87 ng/ml) to 6 months (3.05 +/- A 1.99 ng/ml) and 12 months (2.26 +/- A 1.88 ng/ml) postoperatively, whereas the FSH level increased significantly from baseline to 12 months postoperatively (P < 0.05). Those patients with unilateral endometriomas also had lower levels of AMH in 6 and 12 months after operation. When compared between unilateral and bilateral endometrioma group, the rate of AMH decline 6 and 12 months and the rate of FSH increase 12 months postoperatively reached statistical significance (P < 0.05).The changes of the AMH and FSH values suggest that the ovarian reserve is obviously reduced in spite of suturing technology used as a method of hemostasis after stripping ovarian endometriomas, especially in those with bilateral cysts. The protective effect of the ovarian suturing for ovarian reserve may be marginal.