***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: OBJECTIVE Retrospective studies suggest that laparoscopic excision of endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation . In this study , we prospect ively evaluated ovarian response to hyperstimulation in women selected for in vitro fertilization and intracytoplasmic sperm injection cycles who previously underwent laparoscopic enucleation of a monolateral endometrioma . STUDY DESIGN Operated and contralateral intact  ovaries of the same patient were compared in terms of number of follicles , number of oocytes retrieved , fertilization rate , and rate of high- quality embryos . RESULTS Thirty-eight subjects were included . A reduced number of dominant follicles , oocytes , embryos , and high- quality embryos was observed in the operated gonad . The mean percentage of reduction was 60 % ( 95 % confidence interval 38 - 81 % ) , 53 % ( 95 % confidence interval 30 - 75 % ) , 55 % ( 95 % confidence interval 28 - 81 % ) , and 52 % ( 95 % confidence interval 17 - 87 % ) , respectively . Fertilization rate and rate of good- quality embryos were similar . CONCLUSION Laparoscopic excision of endometriomas is associated with a quantitative but not a qualitative damage to ovarian reserve Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma . The negative impact on ovarian reserve following removal had been documented . Little evidence had been reported for nonovarian originated effects . Objective . To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve , measured by serum antimullerian hormone ( AMH ) , compared to nonovarian pelvic surgery . Material s and Methods . A prospect i ve study was conducted . Women who underwent laparoscopic ovarian cystectomy ( LOC ) and laparoscopic nonovarian pelvic surgery ( NOS )  were recruited and followed up through 6 months . Clinical baseline data and AMH were evaluated . Results . 39 and 38 participants were enrolled in LOC and NOS groups , respectively . Baseline characteristics ( age , weight , BMI , and height ) and preoperative AMH level between 2 groups were not statistically different . After surgery , AMH of both groups decreased since the first week , at 1 month and at 3 months . However , as compared to the LOC group at 6 months after operation , the mean AMH of the NOS group had regained its value with a highly significant difference . Conclusion . This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve . The possible mechanisms are necessary for more investigations AIM We aim ed to evaluate the impact of topical hemostatic sealants and bipolar coagulation during laparoscopic ovarian endometriotic cyst resection on ovarian reserve by comparing the rates of decrease in anti-Müllerian hormone ( AMH ) . METHODS A r and omized prospect i ve data collection was made on women aged 19 - 45 years who planned to have laparoscopic ovarian cystectomy at one of two institutions ( n = 80 ) , Kangbuk Samsung Hospital , Seoul , Korea or National Health Insurance Service Ilsan Hospital , Goyang , Korea , from January 2014 to April 2016 . Patients were r and omly divided into two groups treated with either a topical hemostatic sealant or bipolar coagulation for hemostasis . The hemostatic group was r and omized to the FloSeal or TachoSil subgroups . Preoperative and 3-month postoperative AMH levels were checked and the rates of decrease of AMH were compared . All patients enrolled were treated with dienogest ( Visanne ) for 6 - 12 months . None were lost to follow-up at postoperative 3 months , but about one-third of the patients had been lost to follow-up by 6 - 12 months . RESULTS AMH was significantly decreased in both groups 3 months postoperatively ; however , the rate of decrease in the bipolar coagulation group was greater than that in the hemostatic sealant group , 41.9 % ( interquartile range [ IQR ] , 22.29 - 65.24 ) versus 18.1 % ( IQR , 10.94 - 29.90 ) , P = 0.007 . Between the two hemostatic subgroups , there was no significant difference in AMH decrease rate , 14.95 % ( IQR , 11.34 - 21.21 ) versus 18.1 % ( IQR 9.76 - 40.70 ) , P = 0.204 . CONCLUSION Hemostatic sealants may be an alternative to bipolar coagulation for preservation of ovarian reserve after laparoscopic ovarian cystectomy for endometriosis STUDY QUESTION Is there an association between the endometriosis phenotype and presentation with infertility ? SUMMARY ANSWER In a population of operated patients with histologically proven endometriosis , ovarian endometrioma ( OMA ) per se is not associated with an increased risk of presentation with infertility , while previous surgery for endometriosis was identified as a risk factor for infertility . WHAT IS KNOWN ALREADY The increased prevalence of endometriosis among subfertile women indicates that endometriosis impairs reproduction for reasons that are not completely understood . STUDY DESIGN , SIZE , DURATION This was an observational , cross-sectional study using data prospect ively collected in all non-pregnant patients aged between 18 and 42 years , who were surgically explored for benign gynaecological conditions at our institution between January 2004 and March 2013 . For each patient , a st and ardized question naire was completed during a face-to-face interview conducted by the surgeon during the month preceding surgery . PARTICIPANTS / MATERIAL S , SETTING , METHODS Surgery was performed in 2208 patients , of which 2066 signed their informed consent . Of the 1059 women with a visual diagnosis of endometriosis , 870 had histologically proven endometriosis and complete treatment for their endometriotic lesions , including 307 who presented with infertility . Univariate analysis and multiple logistic regression analysis were performed to determine factors associated with infertility . MAIN RESULTS AND THE ROLE OF CHANCE The following variables were identified as risk factors for endometriosis-related infertility : age > 32 years ( odds ratio [ OR ] = 1.9 ; 95 % confidence interval [ CI ] : 1.4 - 2.4 ) , previous surgery for endometriosis ( OR = 1.9 ; 95 % CI : 1.3 - 2.2 ) , as well as peritoneal superficial endometriosis ( OR = 3.1 ; 95 % CI : 1.9 - 4.9 ) ; Conversely , previous pregnancy was associated with a lower rate of infertility ( OR = 0.7 ; 95 % CI : 0.6 - 0.9 and OR = 0.6 ; 95 % CI : 0.4 - 0.9 , respectively ) . OMA is not selected as a significant risk factor for infertility . LIMITATIONS , REASON FOR CAUTION The selection of our study population was based on a surgical diagnosis . We can not exclude that infertile women with OMA associated with a diminished ovarian reserve , as assessed during their infertility work-up , were referred less frequently to surgery and might therefore be underrepresented . In addition we can not exclude that our group of infertile women present associated other causes of infertility . WIDER IMPLICATION S OF THE FINDINGS Identification of risk and preventive factors of endometriosis-related infertility can help improve clinical and surgical management of endometriosis in the setting of infertility . STUDY FUNDING /COMPETING INTERESTS None . TRIAL REGISTRATION NUMBER None Objective . To evaluate whether a change takes place in antimullerian hormone ( AMH ) levels reflecting the ovarian reserve after  laparoscopic endometrioma stripping surgery  and to demonstrate if there is any correlation between AMH levels and the sizes of endometriomas . Method . Fourty-seven women participated as the study group in this prospect i ve controlled trial , 33 of whom ( 70.2 % ) had unilateral and 14 ( 29.7 % ) of whom had bilateral endometriomas .  Pre- and post-operative serum AMH levels were measured and compared with 17 normo-ovulatory control cases and also correlated with endometrioma sizes . Result ( s ) . Mean pre-operative AMH levels of the study group and the normo-ovulatory control cases did not reveal a statistically significant difference ( 1.62 ± 1.09 ng/ml and 2.06 ± 0.51 ng/ml , P > 0.05 ) . Mean level of post-operative serum AMH of the study group decreased from 1.62 ± 1.09 to 1.39 ± 1.16 . However , this reduction was not statistically significant . ( P > 0.05 ) . Pre- and post-operative AMH levels do not reveal a correlation with the size of endometrioma in both group of patients with either unilateral or bilateral endometrioma . Conclusion ( s ) . The presence of the endometrioma does not impair the AMH levels . Laparoscopic endometrioma stripping surgery do not appear to cause a damage in the AMH secreting healthy ovarian tissue , in the short-term follow-up . Laparoscopic stripping surgery of endometriomas in experienced h and s is currently a valid approach OBJECTIVE To investigate whether the serum antimüllerian hormone ( AMH ) levels recover within 1 year after  cystectomy for endometriomas , and to analyze the pattern of sequential changes in the serum AMH levels . DESIGN Prospect i ve study . SETTING University hospital . PATIENT(S ) Thirty-nine patients undergoing cystectomy for unilateral endometrioma ( n = 22 ) and bilateral endometriomas ( n = 17 ) . INTERVENTION(S ) Serum sample s collected 2 weeks before , and 1 month and 1 year after surgery were assayed for AMH levels . MAIN OUTCOME MEASURE(S ) Assessment of the ovarian reserve damage based on alterations in the serum AMH levels and the association with parameters of endometriosis and surgery for endometriomas . RESULT ( S ) The median AMH levels were 3.56 , 1.90 , and 2.10 ng/mL before , 1 month after , and 1 year after surgery , respectively . Twenty patients showed higher AMH levels 1 year after surgery than 1 month after surgery ( increase group ) ; 19 patients showed lower AMH levels ( decrease group ) . We found a statistically significant difference in the number of follicles removed by surgery between the two groups . CONCLUSION ( S ) The decrease in the serum AMH levels caused by cystectomy can recover . Our results suggest that removal of ovarian cortex might be involved in the decrease of the ovarian reserve just after surgery , and that a continuous decrease of the ovarian reserve after cystectomy might be attributed to other mechanisms Background Endometriosis is a well-known cause of infertility , and the anti-Mullerian hormone ( AMH ) is an accepted biomarker of ovarian reserve and response to artificial reproductive technology procedures . The present study was a prospect i ve analysis of age-dependent AMH serum concentration in women with bilateral and unilateral ovarian endometriomas before therapy onset compared with healthy controls . Methods This prospect i ve cross-sectional study included 384 women aged 18–48 years .  AMH serum concentration  was assessed between days 3 and 6 of the menstrual cycle in 78 patients with bilateral and 157 patients with unilateral ovarian endometriomas and compared with 149 healthy controls . Ovarian endometriosis was confirmed histopathologically , and data were presented as medians with interquartile range ( IQR ) . Results Stage III endometriosis was diagnosed in 53.2 % , stage IV in 18.3 % , stage V in 23.4 % and stage VI in 5.4 % of the patients . Patients with bilateral ovarian endometriomas showed the lowest median AMH levels compared with patients suffering from unilateral ovarian endometriosis ( 0.55 ; IQR : 0.59 vs. 2.00 ; IQR : 2.80 ; p < 0.001 ) and the control group ( 0.55 ; IQR : 0.59 vs. 2.84 ; IQR : 3.2 ; p < 0.001 ) . Median AMH concentration values were not significantly different between patients with unilateral ovarian endometriosis and the healthy controls ( 2.00 ; IQR : 2.80 vs. 2.84 ; IQR : 3.2 ; p = 0.182 ) . A strongly negative correlation between AMH levels and age was confirmed in healthy individuals ( R = −0.834 ; p < 0.001 ) and women with unilateral ovarian endometriomas ( R = −0.774 ; p < 0.001 ) . Patients with bilateral ovarian endometriosis showed a significantly negative but only moderate correlation between AMH levels and age ( R = −0.633 ; p < 0.001 ) , which was significantly lower than in the healthy controls ( R = −0.633 vs. R = −0.834 ; p = 0.0 
    Output:
    
The pre-operative weighted mean difference ( WMD ) showed that serum AMH levels did not differ significantly between the groups .
WIDER IMPLICATION S Our results challenge the concept that endometrioma per se adversely affects ovarian reserve , whereas endometrioma cystectomy , especially as bilateral operation , has a deleterious and sustained effect on ovarian reserve .
AMH seems to be a more appropriate biomarker of ovarian reserve than AFC in cases with endometrioma .