Predictive value of the serum anti-Müllerian level for spontaneous pregnancy in women after endometriosis surgery

J Int Med Res. 2019 Nov;47(11):5643-5649. doi: 10.1177/0300060519861171. Epub 2019 Sep 26.

Abstract

Objective: This study was performed to assess the predictive value of the anti-Müllerian hormone (AMH) serum level for spontaneous pregnancy in women after endometriosis surgery.

Methods: In total, 124 patients with suspected ovarian endometrioma planning to undergo laparoscopic ovarian cystectomy were divided into a high AMH group (AMH > 2 ng/mL) and low AMH group (AMH ≤ 2 ng/mL) according to their preoperative AMH levels. The postoperative AMH levels were also measured, and pregnancy outcomes were followed up.

Results: Twenty-one patients were excluded, and 52 pregnancies were registered in the remaining 103 patients diagnosed with endometriosis. The pregnancy rate was significantly greater in the high than low AMH group. Receiver operator characteristics analysis of preoperative AMH, postoperative AMH, and the AMH decline rate showed that preoperative AMH was associated with the greatest area under the curve. Kaplan–Meier curves showed that women in the high AMH group had a significantly higher cumulative pregnancy rate than those in the low AMH group.

Conclusion: The preoperative AMH level might be a useful marker to predict the occurrence of natural pregnancy and could be offered as part of the fertility strategy to women who desire pregnancy after endometriosis surgery.

Keywords: Anti-Müllerian hormone; cumulative pregnancy rate; endometriosis; fertility; ovarian cystectomy; pregnancy outcome.

MeSH terms

  • Adult
  • Anti-Mullerian Hormone / blood*
  • Area Under Curve
  • Endometriosis / blood*
  • Endometriosis / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Rate

Substances

  • Anti-Mullerian Hormone