Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimüllerian hormone levels

Capsule:
Laparoscopic excision of endometriomas decreases serum AMH levels at 6 weeks and 6 months postoperatively, and the level of decrease is more in cysts that are bilateral or 5 cm.

Authors:
Hale Goksever Celik, M.D., Erbil Dogan, M.D., Emre Okyay, M.D., Cagnur Ulukus, M.D., Bahadir Saatli, M.D., Sezer Uysal, M.D., Meral Koyuncuoglu, M.D.
Volume 97, Issue 6 , Pages 1472-1478, June 2012

Objective:
To investigate the effect of laparoscopic endometrioma stripping on serum antimüllerian hormone (AMH) and the correlation between the clinicopathologic factors.

Design:
Prospective study.

Setting:
University hospital.

Patient(s):
Sixty-five women with endometriomas.

Intervention(s):
All patients underwent laparoscopic cystectomy. Serum AMH, FSH, LH, E2, and antral follicle count (AFC) were measured preoperatively, at 6 weeks, and at 6 months postoperatively. Specimens were analyzed histopathologically.

Main Outcome Measure(s):
The primary end point was to assess the ovarian reserve damage based on alterations of AMH and the secondary end point was to detect the changes in FSH, LH, E2, and AFC.

Result(s):
Serum AMH decreased significantly at the sixth month (61%) postoperatively. The FSH level increased significantly at the sixth week, but returned to normal at the sixth month. The AFC increased significantly at the sixth week and at the sixth month. The AMH level decrease was more evident in patients with the cyst

Conclusion(s):
Laparoscopic cystectomy of ovarian endometriomas causes a significant and progressive decline in serum AMH levels.

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