{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:46:02Z","timestamp":1792007162023,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the ovarian reserve and in\u00a0vitro fertilization\/intracytoplasmic sperm injection (IVF\/ICSI) outcomes after various laparoscopic approaches in infertile patients with endometriomas and suspected compromised ovarian reserve, and the operated and non\u2010operated\/healthy ovaries were also compared, aiming to determine the most appropriate laparoscopic approach for each patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 132 infertile patients with endometriomas and suspected compromised ovarian reserve (anti\u2010M\u00fcllerian hormone [AMH] &lt;2.0\u2009ng\/mL or antral follicle count [AFC] &lt;8) were treated by various laparoscopic approaches at the Sir Run Run Shaw Hospital from January 2021 to December 2023, followed by IVF\/ICSI. Patients were divided into three groups\u2014group A (<jats:italic>n<\/jats:italic>\u2009=\u200933) received anhydrous alcohol instillation, group B (<jats:italic>n<\/jats:italic>\u2009=\u200965) underwent fenestration\/coagulation, and group C (<jats:italic>n<\/jats:italic>\u2009=\u200934) underwent ovarian cystectomy. The clinical characteristics, ovarian reserve, and IVF\/ICSI outcomes were evaluated among the three groups. The operated side and non\u2010operated\/healthy side in patients undergoing initial surgery were also compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of bilateral endometriomas was higher in group A (63.6%, 21\/33) than in group B (40.0%, 26\/65) and group C (32.4%, 11\/34) (<jats:italic>P<\/jats:italic>\u2009=\u20090.023). There was no statistically significant difference in serum AMH in group A before and after surgery (median 1.32 [0.84\u20131.86\u2009ng\/mL] vs. 1.13 [0.59\u20131.86\u2009ng\/mL], <jats:italic>P<\/jats:italic>\u2009=\u20090.098). However, significant postoperative decreases were observed in groups B (median 1.30 [0.97\u20131.76\u2009ng\/mL] vs. 0.91 [0.50\u20131.23\u2009ng\/mL], <jats:italic>P<\/jats:italic>\u2009=\u20090.009) and C (median 1.52 [1.02\u20131.81\u2009ng\/mL] vs. 1.15 [0.76\u20131.67\u2009ng\/mL], <jats:italic>P<\/jats:italic>\u2009=\u20090.006). In group C, the follicle\u2010stimulating hormone\/luteinizing hormone ratio also increased postoperatively (median 1.75 [1.33\u20132.50] vs. 2.29 [1.84\u20133.61], <jats:italic>P<\/jats:italic>\u2009=\u20090.005), while no significant differences were seen in groups A (median 1.72 [1.56\u20132.80] vs. 2.89 [1.89\u20133.54], <jats:italic>P<\/jats:italic>\u2009=\u20090.096) and B (median 2.14 [1.67\u20132.82] vs. 2.37 [1.83\u20133.03], <jats:italic>P<\/jats:italic>\u2009=\u20090.189). The clinical pregnancy rate was significantly higher in group A than in group C (60.6%, 20\/33 vs. 36.4%, 12\/33; <jats:italic>P<\/jats:italic>\u2009=\u20090.042), but not significantly different between groups A and B (60.6%, 20\/33 vs. 46.9%, 30\/64; <jats:italic>P<\/jats:italic>\u2009=\u20090.143) or groups B and C (<jats:italic>P<\/jats:italic>\u2009=\u20090.220). Compared with the control group, there was a statistically significant difference in preoperative AFC in the group anhydrous ethanol instillation side (median 4.0 [2.0\u20135.0] vs. 2.0 [0.75\u20133.25], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), the group fenestration\/coagulation side (median 2.0 [0\u20133.0] vs. 2.0 [0.75\u20133.25], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and the group ovarian cystectomy side (median 2.0 [0\u20134.0] vs. 2.0 [0.75\u20133.25], <jats:italic>P<\/jats:italic>\u2009=\u20090.003), with no significant differences among the three groups themselves. Compared with the control group, significant differences were also observed between the group fenestration\/coagulation side (median 2.0 [1.0\u20133.75] vs. 2.0 [1.0\u20133.0], <jats:italic>P<\/jats:italic>\u2009=\u20090.014) and the group ovarian cystectomy side (median 2.0 [1.0\u20134.0] vs. 2.0 [1.0\u20133.0], <jats:italic>P<\/jats:italic>\u2009=\u20090.040), in the 15\u201320\u2009mm follicles, while no significant differences were found in the group anhydrous ethanol instillation side (median 3.0 [2.0\u20135.0] vs. 2.0 [1.0\u20133.0], <jats:italic>P<\/jats:italic>\u2009=\u20090.108).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that laparoscopic anhydrous ethanol treatment prior to IVF\/ICSI in infertile patients with ovarian endometrioma and suspected compromised ovarian reserve may be superior to fenestration\/coagulation and ovarian cystectomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.70168","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T10:50:52Z","timestamp":1744887052000},"page":"1135-1143","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ovarian reserve and <scp>IVF<\/scp>\/<scp>ICSI<\/scp> outcomes after various laparoscopic approaches in infertility patients with endometriomas and suspected compromised ovarian reserve: A retrospective study"],"prefix":"10.1002","volume":"170","author":[{"given":"Huaying","family":"Yu","sequence":"first","affiliation":[{"name":"Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine Zhejiang University  Hangzhou China"},{"name":"Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology  Hangzhou China"},{"name":"Zhejiang Key Laboratory of Precise Protection and Promotion of Fertility  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