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Background: Ovarian function is affected by the presence of endometrioma and by its management. Treatment of endometrioma should be tailored according to the ovarian reserve.
Aim of the study: To evaluate the role of AMH in guiding the method of surgical management of endometrioma.
Design: Prospective comparative clinical study.
Setting: Gynecology Department-Tanta University and private clinic.
Patients and Methods: 330 women with ovarian endometrioma, complaining of infertility were classified according to AMH level and laterality of endometrioma into 4 groups: group I (120 women) with unilateral endometrioma and AMH above 3ng/ml, group II (80 women) with unilateral endometrioma and AMH below 3 ng/ml, group III (50 women) with bilateral endometrioma and AMH above 2.7 ng/ml and group IV (80 women) with bilateral endometrioma and AMH below 2.7 ng/ml. In groups I and III, laparoscopic ovarian endometrioma resection was done while in groups II and IV, laparoscopic endometrioma drainage with bipolar coagulation was done.
Results: AMH did not decrease significantly in all groups after 3 months, while it decreased significantly after 6 months in groups 2 and 4 and highly significant decrease was found in groups 1 and 3. Endometrioma recurrence occurred in groups (II&IV), while no recurrence occurred in groups (I&III). Conclusion: Laparoscopic management of endometrioma should be guided by serum AMH level and cystectomy should be avoided if lower levels of AMH were found.
Endometrioma, Ovarian, Gynecology, Laparoscopy, Surgeries, Polycystic Ovarian Syndrome, Chronic Pelvic Pain, Prematurity, Prolonged Pregnancy