Introduction: Endometriosis results in impairment of the physiological mechanisms of ovulation, with fewer follicles found in ovaries. The current study aims to assess ovarian reserve (FSH, E2, AMH, and AFC) in infertile patients with endometriosis after laparoscopy
Methodology: This prospective cohort study was done in a private hospital in Saudi Arabia from January 2022 to June 2022. Sixty cases were divided equally into three groups, each 20 patients (after laparoscopy was done): Group 1: Patients with severe endometriosis (stage 3 or 4) as proven by laparoscopy, while Group 2: Patients with minimal or mild endometriosis (stage 1 or 2) as proven by laparoscopy Group 3: Patients with tubal obstruction without endometriosis. Ovarian reserve markers (FSH, E2, AMH, and AFC) were measured pre-operative in all groups and three months post-operative in the group of severe endometrioses. ANOVA and the Post Hoc Turkey test were used to compare the three groups.
Results: Preoperatively, cases of severe endometriosis had significantly lower ovarian reserve than cases with mild endometriosis and no endometriosis regarding AMH (6.5 ± 1.5, 10.75 ± 1.0, 11.15 ± 2.25 with P<0.001) and regarding AMH (1.94 ± 1.06, 1.51 ± 0.86, 2.3 ± 1.0, P=0.048). Surgery further reduced ovarian reserve in the group of severe endometrioses regarding FSH (8.89 ± 2.8, 9.78 ± 2.78, P=0.015), AMH (1.85 ± 1.12, 1.36 ± 0.82, P<0.001), and AFC (6.53 ± 1.62, 7.65 ± 1.37, P<0.001).
Conclusion: Severe endometriosis decreases ovarian reserve, with a further decrease after surgery.