Effects of Combined Laparoscopic Cystectomy and Leuprolide Acetate Therapy on Anti-Mullerian Hormone Level and Antral Follicle Count Profile in Endometriosis

Objective: This study examines the effectiveness of combined laparoscopic cystectomy and leuprolide acetate therapy on AMH level and AFC profile in endometriosis. Method: This study is a randomized controlled clinical trial with open label form. The subjects were divided into control and therapy groups, with the therapy group receiving leuprolide acetate injection following laparoscopic cystectomy. In both groups, the AMH levels and AFC were examined prior to the surgery and six weeks after before they were compared. Results: There were significant pre-post differences of AMH levels(p = 0.000) and AFC (p = 0.000) in the therapy group but not in the control group. In the therapy group, the mean increases of AMH level and AFC were 0.94 (95% CI: 0.63-1.25) and 9.53 (95% CI: 6.83-12.24), respectively. Linear regression model found that AFC level prior to intervention was a significant predictor of endometriosis ASRM grade (p = 0.001) with an R-value of 0.633, suggesting strong correlation. Conclusion: The combined therapy of laparoscopic cystectomy and leuprolide acetate injection for endometriosis provided better outcome concerning ovarian reserve, as opposed to the therapy with laparoscopic cystectomy alone.