Evaluation of Ovarian Reserve and Recurrence Rate After DWLS Diode Laser Ovarian Endometrioma Vaporization (OMAlaser): A Prospective, Single-arm, Multicenter, Clinical Trial

Maurizio Nicola D’Alterio;Luigi Nappi;Salvatore Giovanni Vitale;Mirian Agus;Daniela Fanni;Mario Malzoni;Francesca Falcone;Felice Sorrentino;Maria Gabriella D’Agate;Giuseppe Scibilia;Liliana Mereu;Paolo Scollo;Stefano Angioni

2025-01-01

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Abstract

Study objective: To evaluate the effectiveness of the Dual Wavelength Laser System (DWLS) diode laser on the treatment of ovarian endometrioma (OMA), with ablation and vaporization of the cystic capsule without performing the stripping technique, in terms of ovarian reserve and recurrence rate. Design: Prospective, Single-arm, Multicenter, Clinical Trial SETTING: Multicenter University Hospital. Patients: Seventy patients with symptomatic OMA. Interventions: Patients underwent surgery for primary unilateral or bilateral symptomatic OMA treated with DWLS diode laser vaporization. Following surgical intervention, patients were enrolled in a 12 months surveillance protocol featuring regular clinical assessments aimed at detecting ovarian reserve, pregnancy rate and any recurrence of the cyst and/or symptomatic relapse. Measurements and main results: Antimullerian hormone (AMH) levels at the 3-month follow-up exhibited a significant difference from the baseline (p=0.034), demonstrating a return to nearly presurgical values in the subsequent months. Antral follicle count (AFC) of the operated ovary showed a significant increase after treatment at the 6-month and 12-month follow-up (p=0.005 and p=0.002, respectively). Pregnancies were documented in 48.3% (14/29) of infertile patients who underwent treatment. OMA recurrence was observed in 4 patients (5.7%) at 12 months. No patient exhibited a significant relapse of the analyzed symptoms compared to baseline values. Conclusion: The findings of this study propose that DWLS diode laser presents a good option for treating OMA, demonstrating minimal impact on the surrounding healthy ovarian tissue, favorable pregnancy rate, coupled with low recurrence rates.