In women with ovarian endometrioma, those who receive vasopressin injection during laparoscopic cystectomy experience shorter operation time, have reduced blood loss, and fewer coagulation events, as shown in a study presented at RCOG 2024. 

In addition, injecting vasopressin provides protective benefits to the ovarian reserve, according to lead study author Dr Saeed Marzoq Baradwan from King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia.

Baradwan and his team conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effect of vasopressin injection during laparoscopic injection of endometriomas on ovarian reserve. They searched the databases of PubMed, Cochrane Library, Scopus, and ISI web of science from inception to June 2023.

RCTs comparing vasopressin injection in the intervention group with normal saline or no injection of vasopressin in the control group among women undergoing laparoscopic cystectomy were identified. Seven RCTs, including a total of 440 patients, met the eligibility criteria.

Operation time, the amount of bleeding, and the number of coagulation events were evaluated. Baradwan and colleagues also recorded the levels of serum anti-Mullerian hormone and follicle-stimulating hormone (FSH) for 6 months after surgery.

Women in the vasopressin group had shorter operation time from detaching of the cyst wall until haemostasis of the ovarian tissue than those in the control group (p=0.02). Similarly, the amount of blood loss (p=0.01) and the number of coagulation events (p=0.003) were substantially reduced in the vasopressin group relative to the control group. [RCOG 2024, abstract eP-072]

The concentration of AMH within 6 months after laparoscopic cystectomy significantly improved in the vasopressin group (mean difference, 0.53, 95 percent confidence interval, 0.18?0.88; p=0.003). Moreover, women who received vasopressin injection had a significant reduction in their FSH levels within 6 months after the procedure (p=0.02).

Similar trend

These findings were consistent with those of another study conducted by researchers from Jordan and Qatar. [RCOG 2024, abstract eP-077] 

In the systematic review by Dr Mohammad Ghassab Deameh, Al-Balqa Applied University, Al-Salt, Jordan, and colleagues, vasopressin injection during laparoscopic cystectomy also resulted in significant reductions in bleeding, coagulation events, and operation time when compared with no injection.

Furthermore, differences in the occurrence rate and thickness of ovarian tissue in endometrioma wall specimens were noted between the intervention and control groups in histologic findings by Deameh and colleagues.

"Overall, the findings suggest that vasopressin injection during laparoscopic cystectomy may be beneficial in reducing intraoperative bleeding, improving surgical efficiency, and potentially preserving ovarian function,” Deameh said.

The study by Deameh and his team followed the PRISMA guidelines and used the databases of PubMed, Scopus, and ScienceDirect. They identified RCTs and retrospective cohort studies that compared vasopressin injection with no vasopressin in women undergoing laparoscopic cystectomy. Four studies met the eligibility criteria, including 137 patients in vasopressin groups and 139 in control groups.