Ovarian Reserve Following Medical Therapy in Patients With Endometriosis

Endometriosis is a benign, chronic and recurrent condition characterised by the presence of endometrial glands and stroma outside the uterine cavity. Endometriosis is most frequently localised to the ovary (17 - 44%) and is found in 5-10% of women of childbearing age. In this group of patients, quantification of the ovarian reserve by means of serological and ultrasound markers, in particular antral follicular count (AFC) and blood levels of antimullerian hormone (AMH), is essential. Recent evidence shows that medical hormone therapy, currently the first choice of treatment, affects ovarian endometriosis in terms of volumetric reduction of endometriomas and reduction of local inflammation, but little is known about its effect on ovarian reserve.

Our study therefore aims to evaluate ovarian reserve in terms of AMH and AFC in patients with ovarian endometriosis treated with medical hormone therapy after discontinuation of the latter.

In the clinical trial, patients diagnosed with ovarian endometriosis with an indication for medical therapy undergo 3 blood samples for the determination of antimullerian hormone (AMH) at the same time as 3 medical examinations as per normal care procedure.

Inclusion criteria

• Clinical and ultrasound diagnosis of ovarian endometriosis without indication for surgery
• Age between 18 and 40 years
• Patients desiring pregnancy
• Informed consent obtained

Exclusion criteria

• Endocrinological disorders (including thyroid dysfunction, hyperprolactinaemia and Cushing's syndrome)
• Previous ovarian surgery
• Suspected cyst malignancy