Decline of serum antimüllerian hormone levels after laparoscopic ovarian cystectomy in endometrioma and other benign cysts A prospective cohort study

Capsule:
Bilaterality is the only significant factor in predicting the rate of decline of antim€ullerian hormone levels after laparoscopic ovarian cystectomy.

Authors:
Su Kyoung Kwon, M.D., Sung Hoon Kim, M.D., Ph.D., Sung-Cheol Yun, Ph.D., Dae Yeon Kim, M.D., Ph.D., Hee Dong Chae, M.D., Ph.D., Chung-Hoon Kim, M.D., Ph.D., Byung Moon Kang, M.D., Ph.D.

Volume 101, Issue 2, Pages 435-441, February 2014

Abstract:

Objective:
To identify the most important factor in predicting ovarian reserve after laparoscopic ovarian cystectomy and to evaluate whether there is any difference in the postoperative decline of ovarian reserve between women with endometrioma and those with other benign ovarian cysts.

Design:
Prospective cohort study.

Setting:
University hospital.

Patient(s):
A total of 100 women who had undergone laparoscopic ovarian cystectomy for endometrioma (n = 68) or other benign ovarian cysts (n = 32).

Intervention(s):
Serum antimüllerian hormone (AMH) levels measured by enzyme immunoassay preoperatively and at 3 months after surgery.

Main Outcome Measure(s):
Rate of AMH decline after surgery and follicle numbers retained in cystectomy specimens.

Result(s):
Serum AMH levels were obviously decreased at 3 months after the surgery (4.97 ± 2.83 vs. 3.33 ± 2.08 ng/mL, mean ± standard deviation). Adjusting for several parameters, we could see that bilaterality of the ovarian cyst was the only significant factor in predicting the rate of postoperative decline of AMH levels. The rate of AMH decline did not differ between the endometrioma group and the other benign ovarian cyst group.

Conclusion(s):
Bilaterality of the ovarian cyst is the only significant factor in predicting the rate of decline of AMH level after laparoscopic ovarian cystectomy. The rate of decline of AMH levels after surgery was similar between the endometrioma group and the other benign ovarian cyst group.

  • Lauren Johnson

    Nice study comparing AMH levels before and three months after ovarian cystectomy for endometriomas vs. benign ovarian cysts. The strengths of this study include its
    prospective design, inclusion of a comparison group, and strong statistical
    methods. The authors mention that 56 of the 68 subjects with endometriomas
    received post-operative treatment with a GnRH agonist or OCPs. Were any
    subjects in the benign group treated post-operatively with these agents? Since
    hormone use may result in reductions in AMH levels, it would be interesting to include it as a potential confounder the multivariate model.

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