Can ovarian damage be reduced using hemostatic matrix during laparoscopic endometrioma surgery? A prospective, randomized study.

PURPOSE: To compare the effect of hemostatic matrix (HM) and electrosurgical bipolar coagulation (EBC) on ovarian reserve in patients undergoing endometrioma surgery.

METHODS

Thirty patients with single ovarian endometrioma ≥4 cm were randomized to two groups. Ovarian reserve after laparoscopic excision of endometrioma was assessed by serum anti-Müllerian hormone (AMH); preoperatively and in postoperative months 1 and 3.

RESULTS

The preoperative AMH levels were similar between the groups. Intra-group comparisons: the AMH levels were significantly lower in the first and third postoperative months as compared to basal levels in both groups. In each group, AMH levels were significantly higher in the third postoperative month as compared to first postoperative month. Inter-group comparisons: AMH levels were significantly lower in the EBC as compared to the HM at 1st postoperative month (1.64 ± 0.93 vs. 2.72 ± 1.49 ng/mL). However, the AMH levels were increased and became similar at 3rd postoperative month.

CONCLUSIONS

Although acute ovarian damage was more in EBC group, ovarian reserve was compensated at 3rd month. Further studies with long-term follow-up will clarify the importance of these findings.