Follicular loss in endoscopic surgery for ovarian endometriosis: quantitative and qualitative observations

Abstract

Objective: To identify a possible marker of follicular depletion in relation to some histologic parameters of endometriotic cysts.

Design: Prospective study.

Setting: Università Cattolica del Sacro Cuore, Operative Division of Endocrinological Gynecology.

Patient(s): Seventy-seven patients (aged 20-40 years) with endometrioma.

Intervention(s): Patients underwent laparoscopic surgery for ovarian endometriosis.

Main outcome measure(s): After excision of the cyst wall, involuntarily removed follicles were correlated with age at surgery and with intrinsic histologic parameters of the specimen (thickness and composition of capsule; size of cyst).

Result(s): There was a statistically significant relationship between patient age and number of follicles in the histologic section, a statistically significant inverse relationship between size of cyst and number of follicles, and no significant correlation between thickness of the capsule and number of follicles. Fibroblastic-type capsule, most frequently found in younger patients, was associated with removal of a significantly higher number of follicles.

Conclusion(s): Our study suggests that patient age and cyst dimension are related to the histologic composition of the capsule, which is a marker of the aggressiveness of the cyst itself.