Evaluation of Anti-Mullerian Hormone level as a marker of Ovarian Reserve and correlate it with Laparoscopic Surgery of Pelvic Endometriosis in Subfertile Patients

Sharmin Abbasi, Sehereen Farhad Siddiqua, Mohammad Noor A Alam, Suha Jesmin
In: BIRDEM Medical Journal · 2017 · vol. 8(1) , pp. 30–34 · doi:10.3329/birdem.v8i1.35036 · W2781367190
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This study investigated Anti-Mullerian Hormone (AMH) levels as a marker of ovarian reserve in subfertile patients with endometriosis, finding that AMH significantly decreased before and after laparoscopy, particularly in primary subfertility and after surgical procedures.

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This cross-sectional observational study evaluated anti-Mullerian hormone (AMH) as a marker of ovarian reserve in 59 subfertile women across different stages of pelvic endometriosis, and assessed how laparoscopic surgery and surgical procedures affected AMH. Basal AMH was reported as significantly lower in primary versus secondary subfertility, and AMH decreased after laparoscopy—overall in primary subfertile patients and significantly after surgery involving two ovaries. Mean post-laparoscopy AMH levels were lower in moderate and severe stages, and AMH declined significantly after thermal cauterization and excision plus cauterization. This paper centrally about endometriosis — it specifically links AMH changes to laparoscopic surgery across stages of pelvic endometriosis in subfertile patients.

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Abstract

Background: Endometriosis refers to the presence of endometrial glands and stroma outside the uterine cavity. About 10% causes of infertility are due to endometriosis. In women Anti-Mullerian hormone (AMH) level represents the ovarian follicular pool and has been suggested as the most reliable and reproducible marker to asses ovarian reserve. The gold standard approach of management of endometriosis with subfertility is laparoscopy. The objectives of this stydy are evaluation of AMH levels as a marker of ovarian reserve in subfertile patients with different stages of pelvic endometriosis, and correlate it with laparoscopic surgery.Methods: This was a cross sectional observational study on 59 subfertile patients from January 2014 to January 2017 in Anwer Khan Modern Medical College Hospital (AKMMCH). Main outcome measured on the basis of measurement of AMH levels in correlation with the age, types of subfertility, stages of endometriosis, unilateral or bilateral ovarian involvement, size of the cyst, number of the cyst and the impact of different procedures during laparoscopy on AMH levels.Results: Basal AMH levels significantly lower (p= 0.011 and p =0.001) before and after laparoscopy in primary subfertile patients than secondary subfertile patients and AMH significantly decreased (P<0.024) after laparoscopy in primary subfertile patients. AMH level significantly decreased (P<.001) after laparoscopic surgery of two ovaries. Mean serum AMH levels were decreased in moderate and severe stages of endometriosis after laparoscopy (3.01±.04 ng/ml and 2.15±.03ng/ml). Different surgical procedures of laparoscopy showed significant impact on serum AMH levels, in thermal cauterization (p=0.023) and excision plus cauterization (p=0.001) showed significant decreased of AMH.Conclusion: Serum AMH level decreased in many patients after laparoscopy to such an extent from where future fertility is possible.Birdem Med J 2018; 8(1): 30-34
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Background

Endometriosis refers to the presence of endometrial glands and stroma outside the uterine cavity. About 10% causes of infertility are due to endometriosis. In women Anti-Mullerian hormone (AMH) level represents the ovarian follicular pool and has been suggested as the most reliable and reproducible marker to asses ovarian reserve. The gold standard approach of management of endometriosis with subfertility is laparoscopy. The objectives of this stydy are evaluation of AMH levels as a marker of ovarian reserve in subfertile patients with different stages of pelvic endometriosis, and correlate it with laparoscopic surgery.

Methods

This was a cross sectional observational study on 59 subfertile patients from January 2014 to January 2017 in Anwer Khan Modern Medical College Hospital (AKMMCH). Main outcome measured on the basis of measurement of AMH levels in correlation with the age, types of subfertility, stages of endometriosis, unilateral or bilateral ovarian involvement, size of the cyst, number of the cyst and the impact of different procedures during laparoscopy on AMH levels.

Results

Basal AMH levels significantly lower (p= 0.011 and p =0.001) before and after laparoscopy in primary subfertile patients than secondary subfertile patients and AMH significantly decreased (P<0.024) after laparoscopy in primary subfertile patients. AMH level significantly decreased (P<.001) after laparoscopic surgery of two ovaries. Mean serum AMH levels were decreased in moderate and severe stages of endometriosis after laparoscopy (3.01±.04 ng/ml and 2.15±.03ng/ml). Different surgical procedures of laparoscopy showed significant impact on serum AMH levels, in thermal cauterization (p=0.023) and excision plus cauterization (p=0.001) showed significant decreased of AMH.

Conclusion

Serum AMH level decreased in many patients after laparoscopy to such an extent from where future fertility is possible. Birdem Med J 2018; 8(1): 30-34 Downloads 231 222

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Condition tags

endometriosisinfertility

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References (13)

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