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Impact of endometrioma management strategies on ovarian reserve over the follow-up period, a prospective longitudinal study

  • 0Bursa Uludag University School of Medicine, Department of Obstetrics and Gynecology, Bursa, Türkiye.
Frontiers in Endocrinology +

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September 29, 2025

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September 29, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Endometrioma treatments, including surgery and medications like oral contraceptive pills (OCP) and dienogest, can negatively impact ovarian reserve. Expectant management also showed a decline in ovarian reserve compared to healthy controls.

Area Of Science

  • Reproductive Endocrinology
  • Gynecology
  • Surgical Oncology

Background

  • The impact of endometrioma treatments on ovarian reserve is debated.
  • Surgical techniques and medical therapies may affect ovarian reserve differently.
  • The effect of expectant management on ovarian reserve is not well understood.

Purpose Of The Study

  • To evaluate the effects of endometrioma and its treatment modalities on ovarian reserve.
  • To compare the impact of surgery, oral contraceptive pills (OCP), dienogest, and expectant management on ovarian reserve.

Main Methods

  • Prospective study of 80 women with endometrioma and 20 healthy controls.
  • Participants were divided into four groups: expectant management, OCP, dienogest, and surgery.
  • Serum anti-Müllerian hormone (AMH) levels were measured at baseline and after six months.

Main Results

  • A significant decline in AMH levels was observed in the OCP (26%) and surgery (38%) groups compared to controls (8%).
  • Dienogest (21%) and expectant management (19%) also showed AMH decline, though less pronounced than surgery.
  • Surgical excision of endometriomas poses a risk to ovarian reserve, even with advanced techniques.

Conclusions

  • Surgical treatment of endometriomas negatively impacts ovarian reserve.
  • Dienogest and OCP treatments are associated with decreased AMH levels, with dienogest showing a potentially smaller decline.
  • Expectant management also leads to a decline in ovarian reserve over time.

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