Higher Antral Follicle Count With Hemostatic Sealant After Ovarian Endometrioma Surgery
Hemostatic sealant after laparoscopic cystectomy of ovarian endometriomas led to a greater increase in 3-month antral follicle count postsurgery compared with bipolar coagulation in a recent clinical study (BJOG. 2019;126[10]:1267-1275).
Jacqueline Pui Wah Chung, MBChB, MRCOG ,FHKCOG, FHKAM (O&G), CERT HKCOG (Reprod Med), Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, and colleagues conducted a patient-blinded, controlled trial to study the effect of hemostatic sealant versus bipolar coagulation on ovarian reserve after laparoscopic cystectomy for ovarian endometriomas.
A total of 94 patients with unilateral or bilateral endometriomas 3 cm to 8 cm were included in the study and randomized to receive hemostasis via hemostatic sealant (n = 47) or standard care (n = 47). The primary end point of the study was the effect on the antral follicular count 3 months postsurgery as it captures the effect on the ovary subjected to therapy. The secondary end points included the change in anti-Mullerian hormone, follicular-stimulating hormone, and peri-operative outcomes.
On average, endometriomas were 4.21 cm ± 1.38 cm in diameter. The 3-month antral follicle count increase in affected ovaries in the intervention arm (+2.36 ± 0.37) was significantly higher than in the control arm (+1.08 ± 0.36; P = .013).
For affected ovary antral follicle count, repeated measures analysis of variance showed significant effect with time (P <.001) and of interaction of group by time (P = .029). There were no significant observed between the treatment arms vis-à-vis follicular-stimulating hormone, anti-Mullerian hormone, and other secondary outcomes.
“Applying haemostatic sealant after laparoscopic cystectomy of ovarian endometriomas produced a greater increase in antral follicle count 3 months after surgery compared with the control group,” Dr Chung and colleagues concluded.—Hina Porcelli
