The effects of vasopressin injection technique on ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma: a retrospective cohort study

Objective: To evaluate the effects of vasopressin injection technique (VIT) on ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma. Material and methods: A total of 122 patients with bilateral ovarian endometrioma undergoing laparoscopic cystectomy were assigned to control or the VIT group. Coagulationevent count and blood loss were recorded. Levels of serum anti-Mullerian hormone (AMH) were assessed at 1 day pre-operation, 1 month, 3 months, and 6 months post-operation. The follicles in the tissue sections were counted, and the maximum thickness of cyst wall was measured. Results: Coagulation-event count and blood loss in the VIT group were statistically less than those in control group (P<0.05). In both groups, AMH levels at pre-operation were the highest among different time-points (P<0.05); a remarkable decrease of AMH level was observed at 1 month post-operation, and the values were the lowest among different time-points (P<0.05). At 3 months post-operation, AMH levels gradually increased to approximately 60% of those at pre-operation (P<0.05); at 6 months post-operation, AMH levels were significantly higher than those at 3 months post-operation in VIT group (P<0.05). AMH levels in VIT group were significantly higher than those in control group at each time-point post-operation (P<0.05). The cyst walls in control group were statistically thicker than those in VIT group (P<0.05). Consistent with results of cyst wall thickness, numbers of total follicle loss, primordial and primary follicles in VIT group were less than those of control group (P<0.05). Conclusion: VIT effectively protected ovarian reserve in laparoscopic cystectomy of bilateral ovarian endometrioma.