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document
Hemostasis by bipolar coagulation versus suture after surgical stripping of bilateral ovarian endometriomas : a randomized controlled trial . 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 .
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Intervention_Surgical
bipolar coagulation
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Intervention_Surgical
suture
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Intervention_Surgical
surgical stripping
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Intervention_Surgical
suture of the ovary
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Intervention_Surgical
bipolar coagulation
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Intervention_Surgical
laparoscopic stripping of bilateral endometriomas .
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Intervention_Surgical
stripping of bilateral endometriomas
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Intervention_Surgical
laparoscopic suturing ( LS group )
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Intervention_Surgical
bipolar coagulation ( BC
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Outcome_Physical
Changes in ovarian reserve
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Outcome_Physical
anti-Mullerian hormone ( AMH ) and basal follicle-stimulating hormone ( FSH )
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Outcome_Physical
postsurgical AMH levels
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Outcome_Physical
basal FSH levels
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Outcome_Physical
AMH levels
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Outcome_Physical
basal FSH
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Outcome_Physical
Pregnancy rate , time to conception , and rate of endometrioma recurrence
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Outcome_Physical
serum AMH levels
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Outcome_Physical
basal FSH levels
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Participant_Condition
infertile women undergoing laparoscopic stripping of bilateral endometriomas .
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Participant_Condition
University teaching hospital .