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Objective:To investigate the impact on ovarian reserve function with two different homostatic methods during laparoscopic cystectomy in treatment of endometrioma.Methods:Eighty four cases with unilateral ovarian cysts which located outside of hilum of ovary undergoing laparoscopic surgery were enrolled in the study. Based on hemostasis method, all patients were divided into 2 groups. Study group included 40 cases in ultrasonic scalpel hemostasis. Control group included 44 cases with suture after excision of endometrioma. Before surgery and the 1st, 3rd cycle after surgery, serum FSH, LH and AMH, and ultrasound basal AFC and PSV were examined and compared.Results: The level of FSH, LH, AMH, AFC and PSV had significant difference between before surgery and after surgery 1st, 3rd. The level of FSH, LH, AMH, AFC and PSV had significant difference within group comparisons after surgery 1st, 3rd. The level of serum FSH and LH in study group were lower than these in control group after surgery 1st. The level of serum AMH in study group were higher than in control group after surgery 3st. The level of serum PSV in study group were higher than in control group after surgery 3st.Conclusion: Ovarian reserve function was decresed heavier in ultrasonic scalpel hemostasis during laparoscopic excision of ovarian endometrioma than in suture. Electrocoagulation of the ovarian tissue should be avoided.
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Objective To explore the character and clinical value of high frequency ultrasound in diagnosing abdominal wall endometriomas .Methods The characteristics of the ultrosonographic images in 32 cases with abdomi-nal wall endometriomas by operation and pathology were analyzed retrospectively .Results A total of 33 lesions, including 1 case of multiple (2 lesions),the rest of the 31 cases were single,mostly in the original abdominal incision place or incision side subcutaneous soft tissue ,1 case away from the incision ,located in the inguinal region .26 lesions was located in the subcutaneous fat and 6 lesion in the rectus abdominis muscle .All of the lesions hadn't capsule and were irregular in shape .The internal echo behaved low echo and on homogenous mostly ,one or more small anechoic lacunae could be seen on sonography .CDFI according to Adler semi -quantitative method classification ,25 lesions was 0 level (no blood flow signal),7 lesions for I level (edge had a small amount of pitting,short rod blood flow signal),Pulse doppler performance for low -speed and high-resistance characteristics.Conclusion Combining with the history and clinical performance , high frequency ultrasonography in abdominal wall endometriosis can be made relatively clear diagnosis,surgery of positioning has a guiding significance ,which can be used as the disease choice examination method.
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OBJECTIVE: To compare COH characteristics and IVF outcomes among IVF-ET patients who were treated with various therapeutic modalities for ovarian endometriomas and to propose effective pre-cyclic therapeutic modalities to improve IVF-ET outcomes in the patients with ovarian endometriomas. METHODS: All cases that had undergone IVF-ET after laparoscopy between January 1997 to August 2003 were reviewed. Forty-eight patients with tubal factor were assigned to Group I. Twenty seven, 22 and 38 patients diagnosed as severe pelvic adhesion with ovarian endometriomas by laparoscopy received only medical therapy (Group II), cyst aspiration (Group III), and sclerotherapy (Group IV), respectively. Laparoscopic cystectomy was performed in 20 patients (Group V). Resistance index was measured on day administering hCG. RESULTS: As compared with Group I, in Group II resistance index increased (p<0.05) but number of oocytes, good-quality oocyte ratio (mature and intermediate oocytes/total retrieval oocytes), fertilization rate, and embryo development rate decreased (p<0.05). In Group III fertilization rate and embryo development rate decreased (p<0.05). There was no difference between Group IV and Group I in all parameters except basal FSH which increased (p<0.05). In Group V basal FSH, and resistance increased (p<0.05) and number of oocytes and good-quality oocytes ratio decreased (p<0.05). CONCLUSION: Sclerotherapy is an effective therapeutic option which can be done prior to IVF-ET cycles in the patients with ovarian endometriomas. Further studies on a large scale are necessary to confirm these data.