Evaluation of Ovarian Reserve after Laparoscopic Cystectomy for Endometrioma with or without Vasopressin Injection: A Randomized Clinical Trial Study

Laparoscopic cystectomy for ovarian endometrioma, despite its high usefulness, reduces ovarian reserve; so, several methods are proposed to reduce this problem. This study was designed to evaluate the effect of vasopressin injection in laparoscopic cystectomy on ovarian reserve in patients with unilateral endometrioma. In this clinical trial study, 66 women with unilateral endometrioma undergoing laparoscopic cystectomy were divided into two groups of 33. The first group received vasopressin via injection, and the second group did not received any drug via injection. Anti-Muller hormone (AMH) level before and 6 months after surgery as well as hemoglobin level before and 6 hours after surgery were measured and compared. The mean AMH level before and after the intervention was 3.43 ± 2.46 and 2.67 ± 1.5 ng/ml (P = 0.070), and 3.49 ± 2.48 and 1.61 ± 1.79 ng/ml (P = 0.040) in intervention and control groups, respectively. The level of AMH reduction in vasopressin injection group was lower than control group. The mean hemoglobin level before and after treatment was 11.97 ± 1.12 and 11.29 ± 0.97 (P = 0.69) and 11.5 ± 1.79 and 10.23±1.99 g/dl (P < 0.001) in intervention and control groups, respectively, and blood loss in vasopressin injection group was lower than control group. It seems that vasopressin injection reduce blood-loss, ovarian damage, and the damage to ovarian reserve during laparoscopic cystectomy for ovarian endometrioma.