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Korean Journal of Reproductive Medicine 2008;35(2):155-162.
Published online June 1, 2008.
Assessment of Ovarian Volume and Hormonal Changes after Ovarian Cystectomy in the Different Ovarian Tumor.
Joon Cheol Park, Jin Gon Bae, Jong In Kim, Jeong Ho Rhee
Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, Korea.
OBJECTIVES: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, E2, clomiphene citrate challenge test and ovarian volume. METHODS: Twenty two patients with unilateral ovarian tumor, < or =35 years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, E2 and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. RESULTS: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma > or = 10 cm group (4.79+/-2.57 cm3 and 5.21+/-1.33 cm3, respectively), but not in the non-endometrioma <10 cm group (6.18+/-2.85 cm3). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were 4.25+/-0.20 mIU/ml and 3.79+/-0.80 mIU/ml, 4.24+/-0.85 mIU/ml and 4.28+/-0.92 mIU/ml, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. CONCLUSIONS: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.
Key Words: Endometrioma; Ovarian tumor; Ovarian cystectomy; Ovarian reserve
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