KOSIN UNIVERSITY COLLEGE OF MEDICINE
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- Correlation between serum anti-Müllerian hormone levels and radiological markers assessed using ultrasonography and magnetic resonance imaging in patients with unilateral endometrioma: a retrospective study in Korea
- Hyun Joo Lee, Eun Hee Yu, Jong Kil Joo, Yong Jin Na
- Kosin Med J. 2025;40(3):199-206. Published online September 10, 2025
- DOI: https://doi.org/10.7180/kmj.25.108
- 1,114 View
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Abstract
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- Background
This study aimed to evaluate ovarian reserve in patients with unilateral endometrioma by exploring correlations between serum anti-Müllerian hormone (AMH) levels and imaging markers derived from ultrasonography and magnetic resonance imaging (MRI).
Methods
We conducted a retrospective study of 146 female patients diagnosed with unilateral endometrioma at a single tertiary hospital between 2015 and 2023. Ovarian size was measured using ultrasonography and MRI, and various absolute and relative indicators were calculated. Serum AMH levels and inflammatory markers were assessed, and statistical analyses were performed to examine correlations between AMH levels and imaging markers.
Results
The participants’ mean age and AMH level were 32.01±5.99 years and 3.54±3.24 ng/mL, respectively. Serum AMH levels were significantly negatively correlated with age and body mass index. Among ultrasonographic parameters, only the maximum diameter of the healthy ovary showed a significant positive correlation with AMH levels. Among MRI-derived parameters, the maximum diameter, mean diameter, and volume of the healthy ovary exhibited significant positive correlations with AMH, whereas the relative volume of the affected ovary showed no significant correlation with AMH. These findings suggest that the healthy ovary plays a crucial role in maintaining ovarian reserve.
Conclusions
In women with unilateral endometrioma, the size and volume of the healthy ovary are significantly associated with serum AMH levels. This information is useful for accurately assessing ovarian reserve. These findings highlight the importance of considering the healthy ovary in treatment planning and counseling for women with unilateral endometrioma.
- The conservative management of ovarian endometrioma using cyst aspiration followed by dienogest medication: a pilot study
- Ha Eun Jung, Eun Hee Yu, Hyun Joo Lee, Jong Kil Joo, Yong Jin Na
- Kosin Med J. 2025;40(2):116-121. Published online March 27, 2025
- DOI: https://doi.org/10.7180/kmj.24.149
- 4,775 View
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Abstract
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- Background
The aim of this study was to evaluate the efficacy of ultrasonography-guided cyst aspiration followed by dienogest medication in the management of endometriomas in selected patients.
Methods
This study included 38 female patients diagnosed with endometrioma via transvaginal ultrasonography or pelvic magnetic resonance imaging. We performed needle aspiration of the contents of endometrioma followed by the administration of dienogest (2 mg) daily orally, and assessed changes in endometrioma size, cancer antigen 125, anti-Müllerian hormone, and a visual analog scale score for dysmenorrhea before and 3 months after the procedure.
Results
The diameter of the ovarian cysts decreased from a maximum of 4.35 cm before the procedure to 2.37 cm on follow-up ultrasonography, and seven of 56 endometriomas in 38 patients resolved completely as evaluated on transvaginal ultrasonography. Malignant cells were not found in any of the cases upon a cytologic examination of endometriotic cyst fluid. The mean cancer antigen 125 level decreased from 86.69 U/mL before the procedure to approximately 37.28 U/mL. There was no statistically significant difference in anti-Müllerian hormone before and after the procedure. The visual analog scale score decreased from 3.58 to 0.97 after aspiration.
Conclusions
Ultrasonography-guided cyst aspiration followed by dienogest administration allows cytological confirmation through relatively low-burden procedures and may increase patient compliance due to the reduction in ovarian cyst size.
- Observational Study for Adverse Effects and Discontinuation with Long-Term Post-Operative Hormonal Treatment for Endometriosis in Real-World Practice
- In Hye Kim, Hyungjoon Yoon, Hyun Joo Lee, Hye Kyung Noh, Jong Kil Joo, Ki Hyung Kim
- Kosin Med J. 2021;36(2):116-124. Published online December 31, 2021
- DOI: https://doi.org/10.7180/kmj.2021.36.2.116
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Abstract
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Objectives To evaluate the side effects and causes of discontinuation of either combined oral contraceptives or dienogest (DNG) used to prevent recurrence in patients with surgically confirmed endometriosis.
Methods We retrospectively analyzed the medical records of 213 women with endometriosis who had been treated with combined oral contraceptives (ethinyl estradiol 0.02 mg/drospirenone 3 mg [EE/DRSP]) or DNG 2 mg for 12 months or more. The side effects reported by the patients, laboratory parameters, causes of discontinuation of medication, and recurrence rates were evaluated one, two, three, four, and five years after starting medication (Y1, Y2, Y3, Y4, and Y5).
Results EE/DRSP were administered to 59 patients, while DNG was administered to 154 patients. The mean durations of postoperative use of EE/DRSP and DNG were 44.5 ± 22.6 months and 23.6 ± 13.5 months, respectively. The prevalence of side effects was 27.1%, 19.0%, 10.0%, 10.5%, and 7.4% in the EE/DRSP group and 29.2%, 15.7%, 14.0%, 23.1%, and 0.0% in the DNG group at Y1, Y2, Y3, Y4, and Y5, respectively. The discontinuation rates were 1.7%, 1.7%, 4.0%, 0.0%, and 7.4% at Y1, Y2, Y3, Y4, and Y5, respectively, in the EE/DRSP group and 10.4%, 3.3%, 4.0%, 3.8%, and 0.0% at the same times in the DNG group. The recurrence rates were less than 4% in both the groups.
Conclusions The side effects of commonly prescribed postoperative hormone treatments were relatively mild, and the occurrence of side effects decreased with continuous administration. Further, the long-term use of postoperative hormone treatments is likely to prevent recurrence of endometriosis after surgery.
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