scholarly journals Absorbable Hemostatic Particles to Reduce the Damage on the Follicular Reserve After Ovarian Endometriomas Stripping

Objective: to reduce the surgical damage to the ovarian reserve, after stripping of ovarian endometrioma, of the necrotic type given by the electrohaemostasis or ischemic type given by the suture. Design: perform haemostasis on ovarian parenchyma with topical haemostatic agents. Materials and methods: we used Arista AH which is a powder made up of microporous polysaccharide hemospheres that act by osmotic action and accelerate the natural coagulation process. We used Arista AH in 27 women with mono- or bilateral ovarian endometriosis. Results: in all treated cases we obtained a rapid and optimal haemostasis. There were no post-surgical complications related to haemostatic defects. Three months after the surgery, we checked the Antral Follicle Count (AFC) with a trans-vaginal ultrasound probe. AFC in 24 women with full follow-up gave the following results: unilateral endometrioma – AFC between 5 and 8 (MV: 6.3), bilateral endometriomas – the AFC between 5 and 7 (MV: 5.8). Conclusions: The use of Arista AH powder allows highly effective hemostasis and is easy to use, fully respecting the residual ovarian parenchyma after stripping.

Author(s):  
Vimee Bindra ◽  
Mamatha Reddy ◽  
Girija Shankar Mohanty ◽  
Neha Agarwal ◽  
Aditya Kulkarni

Teratomas are most frequent germ cell tumors of ovary with an incidence of 15%–20% of all ovarian neoplasm while endometriomas are present in 25.5%–45% of women with pelvic endometriosis. In spite of their increased individual incidence, association of cystic teratomas and ovarian endometriomas is extremely rare. Our case is that of a 33-year-old nulligravida who presented with heavy menstrual flow and pain during periods for last few months, ultrasonography revealed 74 × 57 mm mass in right adnexa-likely ovarian dermoid, enlarged left ovary with two small cysts of size 33 × 29 mm and 25 × 20 mm likely endometrioma, managed by laparoscopy, found to have left ovarian endometrioma of 6 × 6 cm and right ovarian dermoid cyst of 10 × 8 cm size, histopathology confirmed the same. This association of teratoma in one ovary and endometrioma in other ovary of same patient poses a surgical challenge, when it affects young and nulliparous women. Further follow up is mandatory for this simultaneous finding of ovarian endometriosis with coincidental dermoid cyst to assess ovarian reserve, recurrence of either of the cysts, and it also presents a challenge to clinicians to predict the post-operative course of such cases.


2017 ◽  
Vol 86 (3) ◽  
pp. 237
Author(s):  
Małgorzata Agnieszka Szczepańska ◽  
Paweł P. Jagodziński ◽  
Ewa Wender‑Ożegowska

An ovarian endometrioma is a very common form of endometriosis in women of reproductive age. This review presents the current state of research on ovarian reserve in women with ovarian endometriomas. Endometrioma can negatively affect ovarian markers: the anti‑Müllerian hormone (AMH), antral follicle count (AFC) and in vitro fertilisation (IVF) results. Decisions on the surgical treatment of endometrial cysts should be carefully thought through, especially in women who have not given birth.


2014 ◽  
Vol 30 (1) ◽  
pp. 250-250 ◽  
Author(s):  
M. L. S. Lima ◽  
C. O. Nastri ◽  
M. A. Coelho Neto ◽  
R. A. Ferriani ◽  
P. A. Navarro ◽  
...  

2013 ◽  
Vol 35 ◽  
pp. 331-335 ◽  
Author(s):  
Emanuela Anastasi ◽  
Lucia Manganaro ◽  
Teresa Granato ◽  
Pierluigi Benedetti Panici ◽  
Luigi Frati ◽  
...  

Background. Surgical excision of ovarian endometriomas in patients desiring pregnancy has recently been criticized because of the risk of damage to healthy ovarian tissue and consequent reduction of ovarian reserve. A correct diagnosis in cases not scheduled for surgery is therefore mandatory in order to avoid unexpected ovarian cancer misdiagnosis. Endometriosis is often associated with high levels of CA125. This marker is therefore not useful for discriminating ovarian endometrioma from ovarian malignancy. The aim of this study was to establish if the serum marker CA72-4 could be helpful in the differential diagnosis between ovarian endometriosis and epithelial ovarian cancer.Methods. Serums CA125 and CA72-4 were measured in 72 patients with ovarian endometriomas and 55 patients with ovarian cancer.Results. High CA125 concentrations were observed in patients with ovarian endometriosis and in those with ovarian cancer. A marked difference in CA72-4 values was observed between women with ovarian cancer (71.0%) and patients with endometriosis (13.8%) ().Conclusions. This study suggests that CA72-4 determination can be useful to confirm the benign nature of ovarian endometriomas in women with high CA125 levels.


2010 ◽  
Vol 94 (6) ◽  
pp. 2340-2342 ◽  
Author(s):  
Benny Almog ◽  
Boaz Sheizaf ◽  
Einat Shalom-Paz ◽  
Fady Shehata ◽  
Ayman Al-Talib ◽  
...  

2020 ◽  
Vol 9 (12) ◽  
pp. 4076
Author(s):  
Stefano Cosma ◽  
Andrea Roberto Carosso ◽  
Martina Moretto ◽  
Fulvio Borella ◽  
Domenico Ferraioli ◽  
...  

Background: The assessment of ovarian reserve in the case of endometrioma is of pivotal importance for planning a tailored management. However, both the antral follicle count (AFC) and the antimüllerian hormone (AMH) dosage are subject to a fair degree of variability in ovarian endometriosis. This study aimed to identify a sonographic parameter of ovarian reserve that could implement current available markers in patients with unilateral endometrioma. Methods: Patients with unilateral endometrioma admitted to our Endometriosis Center between March 2018 and April 2019 were enrolled. Transvaginal ultrasonography for the evaluation of eight sonographic indicators and AMH level determination were performed. The relationship between AMH level and each indicator was assessed. Results: Thirty-four women were included. There was a positive significant correlation between AMH level and the healthy ovary AFC (HO-AFC) (r = 0.36 p = 0.034). A stronger, negative correlation between AMH level and the ratio between the volume of the affected and the healthy ovary (affected ovary relative volume, AORV) (r = −0.47; p = 0.005) was evidenced. AORV had a satisfactory accuracy (AUC 0.73; CI 0.61–0.90; p = 0.0008), and the cut-off value of 5.96 had the best balance of sensitivity/specificity in distinguishing between patients with a good ovarian reserve (AMH ≥ 2 ng/mL) and those at risk of ovarian reserve depletion after excisional surgery. Conclusion: AORV may be a useful tool to assess ovarian reserve in patients with unilateral endometrioma without previous surgery and to guide physicians in clinical management.


2017 ◽  
Vol 29 (1) ◽  
pp. 168 ◽  
Author(s):  
D. Scarlet ◽  
J. Kuhl ◽  
M. Wulf ◽  
N. Ille ◽  
C. Aurich

Success of assisted reproductive techniques, as determined by the response to hormonal treatments and embryo quality, can successfully be predicted by the concentration of anti-Müllerian hormone (AMH) in plasma of several species. Being able to predict ovarian follicular reserve of prepubertal female horses (fillies) would help to select fertile broodmares and reduce costs associated with animal upkeep. The objectives of this work were to (1) assess AMH dynamics in female horses during the first year of life and (2) determine whether AMH concentrations detected in plasma of prepubertal fillies are correlated with AMH concentrations and antral follicle count (AFC) after puberty. Warmblood fillies (n = 14) born from February to May of 1 year in the same stud were used. Blood samples for AMH determinations were collected from birth onward every 4 weeks up to the age of 1 year. At 2 years, blood samples were collected and AFC was determined by transrectal ultrasonography. The AMH concentrations were determined by ELISA (AL-115, Ansh Laboratories, Webster, TX, USA). Transrectal ultrasonography was used to determine the AFC, which corresponds to the total number of antral follicles detected with ultrasound. Statistical analysis was done with the SPSS Statistics 24 software (SPSS Inc., Chicago, IL, USA). The AMH was detectable in the plasma of all animals from birth onward. At birth, mean AMH concentration was 4.5 ± 1.2 ng mL−1. The AMH concentration increased and peaked between 24 weeks (8.7 ± 4.4 ng mL−1) and 28 weeks (6.7 ± 2.1 ng mL−1) and subsequently decreased again (52 weeks: 3.9 ± 0.9 ng mL−1). Very high variation among individuals during the first year was lost at 2 years of age. The AMH concentration at 2 years was highly correlated with AMH concentration at birth (r = 0.62, P < 0.05) and with AFC (r = 0.78, P < 0.001). Also, AMH concentration (r = 0.73, P < 0.01) and AFC (r = 0.6, P < 0.05) at 2 years were highly correlated with AMH concentrations at 24 and 28 weeks. Gestational length (337 ± 1 days), parity of the dam (4.6 ± 0.8), and placental weight (6983 ± 352 g) did not influence AMH concentrations at any time. Our results demonstrate that AMH is detectable in blood of female horses from birth onward. Despite its high variability between individuals up to 52 weeks, strong correlations were observed during the first 2 years of life. High correlations to AFC at 2 years suggest that determination of AMH in prepubertal female horses helps to predict the ovarian reserve and fertility in postpubertal life.


2016 ◽  
Vol 28 (2) ◽  
pp. 257 ◽  
Author(s):  
B. A. Ball ◽  
A. Claes ◽  
T. E. Curry ◽  
M. H. T. Troedsson ◽  
E. L. Squires ◽  
...  

Anti-Müllerian hormone (AMH) is a granulosa-cell derived glycoprotein which plays an important regulatory role during folliculogenesis. Antral follicle count (AFC) and AMH have been used in several species to assess ovarian reserve, but relatively little is known about these parameters in mares. The objectives of this study were to determine (i) plasma AMH concentrations and AFC in mares of different ages, as well as their repeatability within and across oestrous cycles; (ii) the relationship between plasma AMH concentrations and AFC with regard to age and follicle size; and (iii) endocrine and molecular changes in growing and preovulatory follicles in relation to AFC and peripheral AMH concentrations. In Exp. 1, young (3–8 years), middle-aged (9–18 years), and old (>18 years) mares were examined by transrectal ultrasonography over 2 to 3 oestrous cycles and changes in the number and size of all detectable antral follicles were recorded. Concentrations of AMH were determined by ELISA. In Exp. 2, molecular and endocrine differences in growing and dominant equine follicles were examined in relationship to variation in AFC, peripheral AMH concentrations and mare age. Follicular fluid oestradiol and AMH concentrations were determined by immunoassay, and expression of AMH, AMHR2, ESR1, ESR2, FSHR, IGF1, INHA, INHBA, and CYP19A1 was determined by quantitative RT-PCR. Antral follicle counts were significantly lower in old mares than in young and middle-aged mares, and AMH concentrations were significantly lower in old mares than in middle-aged mares. A positive relationship was detected between AFC and AMH, and this relationship varied by mare age with a strong correlation in older mares (ρ = 0.86; P < 0.0001), a moderate correlation in middle-aged mares (ρ = 0.60; P = 0.01), and no correlation (ρ = 0.40, P < 0.4) in young mares. Circulating AMH concentrations were significantly related to the number of antral follicles between 6 and 20 mm in diameter, and the repeatability of AFC and AMH concentrations was high within and between oestrous cycles. Within growing follicles, expression of AMH, AMHR2, ESR2, and INHA in granulosa cells was significantly associated with AFC and plasma AMH concentrations, whereas expression of ESR1 and FSHR were significantly correlated with AMH concentrations alone. In follicular fluid, AMH concentrations declined and oestradiol concentrations increased in dominant compared to growing follicles. Our findings indicate that the relationship between AMH and AFC varies across age groups, and that variations in AFC and plasma AMH concentrations are associated with molecular differences in the equine follicle, which, in turn, may have an impact on follicular function. Funded by the Albert G. Clay Endowment at the University of Kentucky.


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