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Reduced Ovarian Reserve after Excision of Ovarian Endometriomas
S136
Abstracts / Journal of Minimally Invasive Gynecology 17 (2010) S128–S151
478 Reduced Ovarian Reserve after Excision of Ovarian Endometriomas Sheizaf B, Almog B, Shalom-Paz E, Shehata F, Al-Talib A, Tulandi T. Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada Study Objective: To evaluate and compare the response of operated and nonoperated ovaries to gonadotropin stimulation in women whose endometrioma had been excised. Design: A retrospective analysis of the medical records of 38 women who had laparoscopic excision of ovarian endometriomas followed by IVF treatment. Setting: A division of Minimally Invasive Surgery and an IVF unit in a University tertiary hospital’s Obstetrics & Gynecology departement. Patients: 38 women who had laparoscopic excision of unilateral ovarian endometriomas followed by IVF treatment between January 1998 and December 2008. Intervention: The laparoscopy was performed by one surgeon by stripping the cyst wall from the surrounding ovarian tissue. Histopathology confirmed the diagnosis of endometrioma in all patients. Standard IVF protocols were used. hCG was administered when three follicles measured >18mm. Data recorded included demography, operative and pathology reports, laterality of the endometrioma, day 3 basal hormone levels, antral follicle count (AFC), treatment cycle parameters, number of dominant follicles and number of collected oocytes. Measurements and Main Results: 28 women had left ovarian cystectomy, and 10 had right cystectomy. There were 80 IVF cycles in total. The patient’s age was 34.8 4.2 years (mean SD). The average time from operation to IVF-ET cycle was 2.3 1.7 years. The AFC, number of dominant follicles, and number of collected oocytes in the operated ovary were significantly lower than in the non-operated ovaries (Table 1) The proportion of ovaries with at most two dominant follicles and at most two collected oocytes was significantly higher in the operated side compared to the non-operated side. No oocytes were retrieved from 15 (18.75%) operated ovaries and 1 (1.2%)non-operated ovary (P=0.0002). Number of antral follicle count, dominant follicle, and collected oocytes in the operated ovaries and in the nonoperated ovaries
Antral follicle count No. of dominant follicles No. of dominant follicles %2 (%) No. of collected oocytes No. of collected oocytes %2 (%) No. of zero oocytes collected (%)
Operated side (n = 80)
Nonoperated side (n = 80)
P value
4.53.8 4.73.9 24 (30%)
7.45.2 7.54.7 10 (12.5%)
0.003 \0.0001 0.02
1.0–5.0 1.5–4.2 5.1–29.8
4.33.9 32 (40%)
7.44.8 13 (16.2%)
\0.0001 0.008
1.7–4.4 10.3–37.2
15 (18.7%)
1 (1.2%)
0.0002
8.6–26.4
pale nuclei with moderate to marked pleomorphism; increased nuclear to cytoplasmic ratio; cellular crowding and stratification or tufting. These fetures fullfiled the histopathological criteria of atypical endometriosis. Conclusion: We experienced the two cases of atypical endometriosis of the ovary. According to the review of the literature, atypical endometriosis possesses a precancerous potential, which is considered as premalignant changes of endometriosis characterized by cytologic atypia and architecture proliferation. No evidence of reccurence or distant metastasis has been seen in both the patients during the follow-up period.
POSTER SESSION–HYSTEROSCOPY, ENDOMETRIAL ABLATION & STERILIZATION
480 Endometrial Cancer Following Radiofrequency Endometrial Ablation: A Case Report and Systematic Review of the Literature AlHilli MM, Hopkins MR, Famuyide AO. Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
95% CI
Conclusion: Our findings suggest reduced ovarian reserve after excision of ovarian endometrioma. 479 Atypical Endometriosis of the Ovary: A Description of 2 Cases Treated with Laparoscopic Surgery and Review of the Literature Tanase Y, Morioka S, Niiro E, Onogi A, Shigetomi H, Kawaguchi R, Yoshida S, Furukawa N, Yamada Y, Oi H, Kobayashi H. Obstetrics and Gynecology, Nara Medicak University, Kashihara, Nara, Japan Study Objective: To describe the clinical characteristics and fetures of atypical endometriosis. Design: Case report and review of the literature. Setting: A university hospital, Nara Medical University, Japan. Patients: We retrospectively reviewed the charts of two women with atypical endometriosis of the ovary.They were treated between July 2008 and March 2010 at out hospital. Intervention: Under general anethsia, total laparscopic cystectomy was performed with both the patients. Measurements and Main Results: The cysts of the two cases showed typical fetures, included eosinophilic cytoplasm; large hyperchromatic or
Study Objective: Data on the occurrence of endometrial cancer (EC) following endometrial ablation (EA) are limited. It is unknown whether the destruction of the endometrium may diminish the rate of diagnosis of
Abstracts / Journal of Minimally Invasive Gynecology 17 (2010) S128–S151
478 Reduced Ovarian Reserve after Excision of Ovarian Endometriomas Sheizaf B, Almog B, Shalom-Paz E, Shehata F, Al-Talib A, Tulandi T. Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada Study Objective: To evaluate and compare the response of operated and nonoperated ovaries to gonadotropin stimulation in women whose endometrioma had been excised. Design: A retrospective analysis of the medical records of 38 women who had laparoscopic excision of ovarian endometriomas followed by IVF treatment. Setting: A division of Minimally Invasive Surgery and an IVF unit in a University tertiary hospital’s Obstetrics & Gynecology departement. Patients: 38 women who had laparoscopic excision of unilateral ovarian endometriomas followed by IVF treatment between January 1998 and December 2008. Intervention: The laparoscopy was performed by one surgeon by stripping the cyst wall from the surrounding ovarian tissue. Histopathology confirmed the diagnosis of endometrioma in all patients. Standard IVF protocols were used. hCG was administered when three follicles measured >18mm. Data recorded included demography, operative and pathology reports, laterality of the endometrioma, day 3 basal hormone levels, antral follicle count (AFC), treatment cycle parameters, number of dominant follicles and number of collected oocytes. Measurements and Main Results: 28 women had left ovarian cystectomy, and 10 had right cystectomy. There were 80 IVF cycles in total. The patient’s age was 34.8 4.2 years (mean SD). The average time from operation to IVF-ET cycle was 2.3 1.7 years. The AFC, number of dominant follicles, and number of collected oocytes in the operated ovary were significantly lower than in the non-operated ovaries (Table 1) The proportion of ovaries with at most two dominant follicles and at most two collected oocytes was significantly higher in the operated side compared to the non-operated side. No oocytes were retrieved from 15 (18.75%) operated ovaries and 1 (1.2%)non-operated ovary (P=0.0002). Number of antral follicle count, dominant follicle, and collected oocytes in the operated ovaries and in the nonoperated ovaries
Antral follicle count No. of dominant follicles No. of dominant follicles %2 (%) No. of collected oocytes No. of collected oocytes %2 (%) No. of zero oocytes collected (%)
Operated side (n = 80)
Nonoperated side (n = 80)
P value
4.53.8 4.73.9 24 (30%)
7.45.2 7.54.7 10 (12.5%)
0.003 \0.0001 0.02
1.0–5.0 1.5–4.2 5.1–29.8
4.33.9 32 (40%)
7.44.8 13 (16.2%)
\0.0001 0.008
1.7–4.4 10.3–37.2
15 (18.7%)
1 (1.2%)
0.0002
8.6–26.4
pale nuclei with moderate to marked pleomorphism; increased nuclear to cytoplasmic ratio; cellular crowding and stratification or tufting. These fetures fullfiled the histopathological criteria of atypical endometriosis. Conclusion: We experienced the two cases of atypical endometriosis of the ovary. According to the review of the literature, atypical endometriosis possesses a precancerous potential, which is considered as premalignant changes of endometriosis characterized by cytologic atypia and architecture proliferation. No evidence of reccurence or distant metastasis has been seen in both the patients during the follow-up period.
POSTER SESSION–HYSTEROSCOPY, ENDOMETRIAL ABLATION & STERILIZATION
480 Endometrial Cancer Following Radiofrequency Endometrial Ablation: A Case Report and Systematic Review of the Literature AlHilli MM, Hopkins MR, Famuyide AO. Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
95% CI
Conclusion: Our findings suggest reduced ovarian reserve after excision of ovarian endometrioma. 479 Atypical Endometriosis of the Ovary: A Description of 2 Cases Treated with Laparoscopic Surgery and Review of the Literature Tanase Y, Morioka S, Niiro E, Onogi A, Shigetomi H, Kawaguchi R, Yoshida S, Furukawa N, Yamada Y, Oi H, Kobayashi H. Obstetrics and Gynecology, Nara Medicak University, Kashihara, Nara, Japan Study Objective: To describe the clinical characteristics and fetures of atypical endometriosis. Design: Case report and review of the literature. Setting: A university hospital, Nara Medical University, Japan. Patients: We retrospectively reviewed the charts of two women with atypical endometriosis of the ovary.They were treated between July 2008 and March 2010 at out hospital. Intervention: Under general anethsia, total laparscopic cystectomy was performed with both the patients. Measurements and Main Results: The cysts of the two cases showed typical fetures, included eosinophilic cytoplasm; large hyperchromatic or
Study Objective: Data on the occurrence of endometrial cancer (EC) following endometrial ablation (EA) are limited. It is unknown whether the destruction of the endometrium may diminish the rate of diagnosis of