Impact of endometrioma surgery on ovarian reserve: a prospective, randomized, pilot study comparing stripping with CO laser vaporization in patients with bilateral endometriomas

• Published in: Journal of international medical research Vol. 48
• Main Authors: Mariona Rius, Meritxell Gracia, Cristina Ros, María-Ángeles Martínez-Zamora, Cristian deGuirior, Lara Quintas, Francisco Carmona
• Format: Journal Article
• Language: English
• Published: SAGE Publishing 01.06.2020
• ISSN: 1473-2300
• DOI: 10.1177/0300060520927627

Objective To assess ovarian reserve through antral follicle count (AFC) and ovarian volume (OV) determination after decapsulation (stripping technique) or CO 2 laser vaporization in the surgical treatment of patients with bilateral ovarian endometriomas. Methods This prospective, randomized, blinded, self-controlled pilot study was set in a tertiary university hospital between January 2017 and December 2017, and included consecutive patients with bilateral ovarian endometriomas ≥3 cm. The study was registered with ClinicalTrials.gov under the title ‘Impact on ovarian reserve according to the type of ovarian endometrioma excision: laser versus conventional cystectomy’; NCT 03826355. For each patient, the endometrioma on one side was randomly selected to undergo CO 2 laser vaporization and the contralateral endometrioma to undergo laparoscopic decapsulation. Results A total of 16 patients were included. There were no statistically significant between-group differences in OV and AFC levels at baseline. At the 6-month follow-up, OV and AFC levels were significantly higher in the laser-treated group versus the stripping technique. Conclusion Lower OV and AFC levels following excisional surgery for endometrioma versus CO 2 laser vaporization suggest a higher impact on ovarian reserve after the stripping procedure.