Hemostasis by Bipolar Coagulation Versus Suture After Surgical Stripping of Bilateral Ovarian Endometriomas: A Randomized Controlled Trial

被引:63
作者
Ferrero, Simone [1 ,2 ]
Venturini, Pier Luigi [1 ,2 ]
Gillott, David John [3 ]
Remorgida, Valentino [1 ,2 ]
Maggiore, Umberto Leone Roberti [1 ,2 ]
机构
[1] San Martino Hosp, Dept Obstet & Gynecol, I-16132 Genoa, Italy
[2] Univ Genoa, Genoa, Italy
[3] Queen Mary Univ London, St Bartholomews Sch Med & Dent, London, England
关键词
AMH level; Bipolar coagulation; Endometrioma; FSH level; Stripping; ANTI-MULLERIAN HORMONE; ANTRAL FOLLICLE COUNT; LAPAROSCOPIC EXCISION; CYSTECTOMY; SURGERY; FENESTRATION; INJECTION; RESERVE;
D O I
10.1016/j.jmig.2012.08.001
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study objective: To estimate whether the suture of the ovary is superior to bipolar coagulation in preserving ovarian reserve in infertile women undergoing laparoscopic stripping of bilateral endometriomas. Design: Randomized controlled trial (Canadian Task Force classification I). Setting: University teaching hospital. Patients: 100 patients with bilateral endometriomas. Interventions: Patients underwent stripping of bilateral endometriomas and were randomized to undergo hemostasis by use of either laparoscopic suturing (LS group) or bipolar coagulation (BC group). Changes in ovarian reserve were investigated by measuring the levels of anti-Mullerian hormone (AMH) and basal follicle-stimulating hormone (FSH) before surgery and at 3, 6 and 12 months from surgery. Measurements and Main Results: At 3-month, 6-month, and 12-month follow-up, in both study groups, postsurgical AMH levels were significantly lower and basal FSH levels were significantly higher than before surgery. There was no significant difference in the mean percentage decrease of AMH levels in the BC group and LS group at 3-, 6-, and 12-month follow-up. The mean percentage increase in basal FSH was higher in the BC group than in the LS group at both 3-month (p = .023) and 6-month follow-up (p = .029), but not at 12-month follow-up. Pregnancy rate, time to conception, and rate of endometrioma recurrence was similar in the 2 study groups. Conclusion: Laparoscopic stripping of ovarian endometriotic cyst significantly decreases serum AMH levels and increases basal FSH levels independent from the method used to obtain hemostasis on the ovarian tissue. Journal of Minimally Invasive Gynecology (2012) 19, 722-730 (C) 2012 AAGL. All rights reserved.
引用
收藏
页码:722 / 730
页数:9
相关论文
共 38 条
[1]   A prospective, randomized study comparing laparoscopic ovarian cystectomy versus fenestration and coagulation in patients with endometriomas [J].
Alborzi, S ;
Momtahan, M ;
Parsanezhad, ME ;
Dehbashi, S ;
Zolghadri, J ;
Alborzi, S .
FERTILITY AND STERILITY, 2004, 82 (06) :1633-1637
[2]   A comparison of follicular response of ovaries to ovulation induction after laparoscopic ovarian cystectomy or fenestration and coagulation versus normal ovaries in patients with endometrioma [J].
Alborzi, Saeed ;
Ravanbakhsh, Romina ;
Parsanezhad, Mohammad E. ;
Alborzi, Mehrnoosh ;
Alborzi, Soroosh ;
Dehbashi, Sedigheh .
FERTILITY AND STERILITY, 2007, 88 (02) :507-509
[3]   Effects of excision of ovarian endometrioma on the antral follicle count and collected oocytes for in vitro fertilization [J].
Almog, Benny ;
Sheizaf, Boaz ;
Shalom-Paz, Einat ;
Shehata, Fady ;
Al-Talib, Ayman ;
Tulandi, Togas .
FERTILITY AND STERILITY, 2010, 94 (06) :2340-2342
[4]  
[Anonymous], 1999, WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction
[5]   Rate of severe ovarian damage following surgery for endometriomas [J].
Benaglia, Laura ;
Somigliana, Edgardo ;
Vighi, Valentina ;
Ragni, Guido ;
Vercellini, Paolo ;
Fedele, Luigi .
HUMAN REPRODUCTION, 2010, 25 (03) :678-682
[6]   Randomized clinical trial of two laparoscopic treatments of endometriomas: cystectomy versus drainage and coagulation [J].
Beretta, P ;
Franchi, M ;
Ghezzi, F ;
Busacca, M ;
Zupi, E ;
Bolis, P .
FERTILITY AND STERILITY, 1998, 70 (06) :1176-1180
[7]   Postsurgical ovarian failure after laparoscopic excision of bilateral endometriomas [J].
Busacca, Mauro ;
Riparini, Jennifer ;
Somigliana, Edgardo ;
Oggioni, Giulia ;
Izzo, Stefano ;
Vignali, Michele ;
Candiani, Massimo .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2006, 195 (02) :421-425
[8]  
Canis M, 1997, FERTIL STERIL, V67, P817
[9]   Ovarian response during IVF-embryo transfer cycles after laparoscopic ovarian cystectomy for endometriotic cysts of >3 cm in diameter [J].
Canis, M ;
Pouly, JL ;
Tamburro, S ;
Mage, G ;
Wattiez, A ;
Bruhat, MA .
HUMAN REPRODUCTION, 2001, 16 (12) :2583-2586
[10]   Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Mullerian hormone levels [J].
Chang, Hye Jin ;
Han, Sang Hoon ;
Lee, Jung Ryeol ;
Jee, Byung Chul ;
Lee, Byoung Ick ;
Suh, Chang Suk ;
Kim, Seok Hyun .
FERTILITY AND STERILITY, 2010, 94 (01) :343-349