History of Laparotomy
Another prognostic factor found is presence of history of laparotomy. In
our results, laparotomy rate was 54.5% in CC group and 13.5% in ETC
group. (p<0.01) and the difference was statistically
significant. It’s an ongoing debate whether laparotomy decreases ovarian
reserve. There are studies about surgery in endometriosis and results
indicate that laparoscopy may have more detrimental effects on ovarian
reserve than laparotomy.(18) But adversely; our results indicated that
the ovarian reserve was worse in the patients whom operated by
laparotomy than laparoscopy. (Table –10) We didn’t know the ovarian
reserve of the patients before surgery, so we couldn’t interpret the
effect of surgery type on ovarian reserve. Furthermore we didn’t know
whether stripping or coagulation were used during endometrioma excision.
As the result we may conclude that (excluding contributing factors)
presence of laparotomy history has negative impact on ovarian reserve.