{"paper_id":"21659121-d51f-488e-adc9-4f7e5b672416","body_text":"Longterm follow-up of anti-müllerian hormone levels in patients who had surgery for endometrioma\nDate\n2019-04\nAuthors\nJournal Title\nJournal ISSN\nVolume Title\nPublisher\nStellenbosch : Stellenbosch University\nAbstract\nIntroduction:\nEndometriosis is highly prevalent among women of reproductive age increasing up\nto 50% in those presenting with infertility. Ovarian endometriosis, known as\nendometriomas, is found in up to 44% of women with endometriosis. Excisional\nsurgery for endometrioma in the form of cystectomy is associated with a reduction in\novarian reserve as measured by anti-Müllerian hormone (AMH). Although there are\nreports of recovery of AMH levels following cystectomy, the long-term effects of this\nsurgery on ovarian reserve is unknown.\nObjective and Methods:\nThe primary objective is to investigate whether there is recovery of serum anti-\nMüllerian hormone (AMH) level in the long-term (more than 1 year) after cystectomy\nfor endometriomas, with a secondary objective to determine the on-going pregnancy\nrate in the group of patients trying to conceive. We performed a longitudinal cohort\nstudy in a tertiary referral unit evaluating fifty-nine patients that underwent\nlaparoscopic cystectomy for suspected endometrioma. We analysed data on serum-\nAMH levels of samples collected before or on the day of surgery, 6 months after\nsurgery and at a mean final follow-up of 23.3 months after surgery. For our secondary outcome we determined a documented clinical pregnancy in patients that\nwhished to conceive Results:\nThe serum AMH levels declined in 92% of patients at final follow-up. A significant\ndecline in serum AMH of -1.23ng/ml and -1.47ng/ml was detected at 6 months and\nfinal follow-up respectively. We demonstrated an on-going pregnancy rate of 38% in\nthe groups trying to conceive.\nConclusion:\nThe reduction in ovarian reserve following cystectomy as measured by serum AMH\ndoes not recover in the overwhelming majority of patients. Patients need to be\ncounselled regarding this possibility and alternative fertility sparing options should be\nconsidered in the management of endometriomas in women still wishing to conceive\nDescription\nThesis (Mphil)--Stellenbosch University, 2019.\nKeywords\nEndometriosis, anti-Müllerian hormone, UCTD, Laparoscopic surgery, Human reproduction","source_license":"CC0","license_restricted":false}