The effect of vasopressin injection on ovarian reserve in patients with ovarian endometrioma: a randomized controlled trial

Research question: Does injecting vasopressin into the mesovarium during endometrioma cystectomy further preserve postoperative ovarian reserve by reducing intraoperative bleeding and electrocoagulation points?Design: Randomized controlled trial conducted between March 2016 and March 2020. One hundred and twenty patients with unilateral and unilobulated endometrioma were included and divided into two groups: group 1 (n = 60) comprised all patients with ovarian cystectomy after vasopressin injection in the mesovarium space; group 2 included the controls. In both groups, the anti-Mullerian hormone (AMH) concentration was examined before surgery and 3, 6 and 12 months after surgery. In both groups, the number of bipolar cauterization points and the amount of bleeding during cystectomy as well as the pain symptoms related to endometriosis and pregnancy rate were further assessed and compared.Results: Compared with the vassopressin group, the controls had significantly higher haemostasis points and bleeding (P = 0.0001). No significant difference was found between the two groups in serum AMH concentration at 3, 6 and 12 months after surgery. A significant reduction in pain symptoms was reported in both groups 6 months after surgery (P = 0.0001). No significant difference was found between the two groups in spontaneous pregnancy, miscarriage rate and pregnancy time after surgery.Conclusion: Despite the reduction in the amount of bleeding and electrocoagulation points in the vasopressin group, ovarian reserve had a similar downward trend in both groups, which is attributed to the nature of these cysts.

Automated summary

Injecting vasopressin into the mesovarium during endometrioma cystectomy can reduce intraoperative bleeding and electrocoagulation points, but it does not have a significant effect on preserving ovarian reserve.