The impact of excision of benign nonendometriotic ovarian cysts on ovarian reserve: a systematic review.

Autor: Mohamed AA; Royal Derby Hospital, University of Nottingham, Derby, United Kingdom., Al-Hussaini TK; Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt., Fathalla MM; Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt., El Shamy TT; Royal Derby Hospital, University of Nottingham, Derby, United Kingdom., Abdelaal II; Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt., Amer SA; Royal Derby Hospital, University of Nottingham, Derby, United Kingdom. Electronic address: saad.amer@nottingham.ac.uk.
Jazyk: angličtina
Zdroj: American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2016 Aug; Vol. 215 (2), pp. 169-76. Date of Electronic Publication: 2016 Apr 05.
DOI: 10.1016/j.ajog.2016.03.045
Abstrakt: Background: Benign nonendometriotic ovarian cysts are very common and often require surgical excision. However, there has been a growing concern over the possible damaging effect of this surgery on ovarian reserve.
Objective: The aim of this metaanalysis was to investigate the impact of excision of benign nonendometriotic ovarian cysts on ovarian reserve as determined by serum anti-Müllerian hormone level.
Data Sources: MEDLINE, Scopus, ScienceDirect, and Embase were searched electronically.
Study Design: All prospective and retrospective cohort studies as well as randomized trials that analyzed changes of serum anti-Müllerian hormone concentrations after excision of benign nonendometriotic cysts were eligible. Twenty-five studies were identified, of which 10 were included in this analysis.
Data Extraction: Two reviewers performed the data extraction independently.
Results: A pooled analysis of 367 patients showed a statistically significant decline in serum anti-Müllerian hormone concentration after ovarian cystectomy (weighted mean difference, -1.14 ng/mL; 95% confidence interval, -1.36 to -0.92; I(2) = 43%). Subgroup analysis including studies with a 3-month follow-up, studies using Gen II anti-Müllerian hormone assay and studies using IOT anti-Müllerian hormone assay improved heterogeneity and still showed significant postoperative decline of circulating anti-Müllerian hormone (weighted mean difference, -1.44 [95% confidence interval, -1.71 to -1.1; I(2) = 0%], -0.88 [95% confidence interval, -1.71 to -0.04; I(2) = 0%], and -1.56 [95% confidence interval, -2.44 to -0.69; I(2) = 22%], respectively). Sensitivity analysis including studies with low risk of bias and excluding studies with possible confounding factors still showed a significant decline in circulating anti-Müllerian hormone.
Conclusion: Excision of benign nonendometriotic ovarian cyst(s) seems to result in a marked reduction of circulating anti-Müllerian hormone. It remains to be established whether this reflects a real compromise to ovarian reserve.
(Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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