Synthesis of results
The postoperative serum AMH levels (Figure 3) of the endometrioma patients in the electrocoagulation group were significantly lower than those of the nonthermal hemostatic method group at postoperative one month (mean difference [MD] 0.72, 95% confidence interval (CI) [0.42, 1.03]), three months ([MD]0.68, 95% CI [0.27, 1.09]), six months ([MD] 0.65, 95% CI [0.27, 1.03]), and 12 months ([MD] 0.86, 95% CI [0.69, 1.04]). These findings suggest a more pronounced negative impact of electrocoaguation on the ovarian reserve of endometrioma patients 3, 16, 17, 20, 24, 25. However, when analyzing patients with benign ovarian cysts, no significant difference was found between the two groups at postoperative three months ([MD] -0.13, 95%CI [-1.61, 1.35]), six months ([MD] 0.3, 95% CI [0.02, 0.59]), and 12 months ([MD] 0.39, 95% CI [-1.13, 1.91]). The funnel plot indicated the absence of significant publication bias for the outcome of postoperative 3-month serum AMH.
When comparing the two groups with regard to AFC 4, 17, 19, 22, 24(Figure 4.), a statistically significant decrease was observed in the endometrioma subgroup at postoperative months 1, 3, and 12. Nevertheless, the AFC difference was insignificant in the studies including various types of benign ovarian cysts 4, 19.