Table 1_The influence of ovarian cyst type and size on ovarian reserve markers: implications for fertility counseling and preservation strategy.docx

BackgroundOvarian cysts are common in reproductive-aged women and may affect ovarian reserve, thereby impacting fertility potential. This study aimed to evaluate the differential impact of various ovarian cyst types and sizes on ovarian reserve markers to inform individualized fertility care. MethodsA retrospective cohort study was conducted on 474 women classified into four groups: endometrioma, simple cyst, dermoid cyst, and controls without cysts. Serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) levels, and antral follicle count (AFC) were assessed. Multivariate regression analyses adjusted for age and BMI were used to evaluate the independent effects of cyst type and size on ovarian reserve markers. ResultsCompared to controls, women with ovarian cysts had significantly lower AMH and AFC levels and higher FSH levels (all p < 0.001). Endometriomas exerted the most profound negative impact, with the lowest AMH and AFC values and the highest FSH levels. Larger cysts were independently associated with greater reductions in AMH and AFC and increases in FSH levels. ConclusionBoth ovarian cyst type and size significantly influence ovarian reserve. Endometriomas and larger cysts are particularly detrimental. These findings highlight the need for personalized fertility counseling and early preservation strategies in affected women.背景：卵巢囊肿在育龄女性中较为常见，可影响卵巢储备功能，进而对生育潜能造成不良影响。本研究旨在评估不同类型、不同大小的卵巢囊肿对卵巢储备标志物的差异化影响，为个体化生育诊疗提供依据。 方法：本研究为回顾性队列研究，共纳入474名女性，分为4组：子宫内膜异位囊肿（endometrioma）、单纯性囊肿（simple cyst）、皮样囊肿（dermoid cyst）及无囊肿对照组。检测受试者血清抗缪勒管激素（anti-Müllerian hormone, AMH）、促卵泡生成素（follicle-stimulating hormone, FSH）水平及窦卵泡计数（antral follicle count, AFC）。采用校正年龄与体质量指数（BMI）的多因素回归分析，评估囊肿类型与大小对卵巢储备标志物的独立影响。 结果：与对照组相比，卵巢囊肿患者的血清AMH与AFC水平显著降低，FSH水平显著升高（所有指标P均<0.001）。其中子宫内膜异位囊肿的负面影响最为显著，患者AMH与AFC水平最低、FSH水平最高。囊肿体积越大，其对应的AMH与AFC降幅、FSH升幅均更为显著，且该关联独立存在。 结论：卵巢囊肿的类型与大小均可显著影响卵巢储备功能，其中子宫内膜异位囊肿与体积较大的囊肿危害尤为突出。本研究结果提示，需对卵巢囊肿患者开展个体化生育咨询，并尽早采取卵巢储备保护策略。