Effect of age and stage of endometriosis on ovarian follicular loss during laparoscopic cystectomy for endometrioma.

Objective: To identify the risk factors associated with inadvertent follicular loss during laparoscopic cystectomy for endometrioma.

Methods: Between April 2008 and April 2010, 114 patients who underwent laparoscopic cystectomy for endometrioma were enrolled in the study. Clinical data were collected, together with a retrospective review of medical records. Ovarian follicular loss and the thickness of the cystic wall removed were evaluated by pathologic slide review.

Results: Ovarian follicular loss was more frequently observed among younger patients (P < 0.001) and those with stage 3 endometriosis than among those with stage 4 (P = 0.027), in addition to having an inverse correlation with age (P < 0.001). The thickness of the removed ovarian tissue correlated with inadvertent follicular loss (P < 0.001); however, there was no correlation between any clinical parameter tested and the thickness of the removed ovarian tissue. There was a correlation between ovarian follicular loss and the thickness of the removed ovarian tissue among patients younger than 40 years (P < 0.001), but not among patients aged 40 years or older (P = 0.123).

Conclusion: Ovarian follicular loss was more common among younger patients and patients with lower-stage endometriosis. The thickness of the removed ovarian tissue did not differ among patients, despite varying clinical factors.