Changes in serum antimüllerian hormone levels in patients 6 and 12 months after endometrioma stripping surgery

Abstract

Objective: To investigate the impact of laparoscopic endometrioma cystectomy on the ovarian reserve and to identify the most important factors that predict the ovarian reserve in patients with endometriomas.

Design: Prospective study.

Settings: Endoscopy unit of a general hospital.

Patient(s): Fifty-four patients with unilateral (n = 37) and bilateral endometriomas (n = 17).

Interventions(s): The serum antimüllerian hormone (AMH) concentration was assessed before surgery and at 6 and 12 months after surgery.

Main outcome measure(s): The primary outcome was the damage to the ovarian reserve, as assessed by the serum AMH concentration. Secondary end points were the persistence or recovery of ovarian damage after 1 year.

Result(s): AMH concentrations decreased after the laparoscopic excision of cystic ovarian endometriomas. Before surgery and at 6 and 12 months after surgery, the concentrations were, respectively 3.07, 1.29, and 1.46 ng/mL. In the unilateral group, the median AMH levels were 3.31, 1.43, and 1.72 ng/mL, and in the bilateral group the levels were 2.55, 0.98, and 0.89 ng/mL. The serum AMH concentrations thus decreased by 53.27 ± 38.2% and 49.43 ± 38.3% at 6 and 12 months after cystectomy, respectively.

Conclusion(s): In patients with endometriomas, the decrease in ovarian reserve occurs immediately after the excision of the endometrioma. Significant predictors of AMH values at 6 and 12 months after surgery include the baseline AMH level, patient age, and bilateral endometriomas.

Keywords: Endometrioma; antimüllerian hormone; laparoscopy; ovarian reserve.