The Effect of Laparoscopic Endometrioma Surgery on Anti-Müllerian Hormone: A Systematic Review of the Literature and Meta-Analysis

Jose Antonio Moreno-Sepulveda, Carolina Romeral, Geraldine Niño, Geraldine Victoria Ruiz Niño, Assumpció Pérez-Benavente, Assumpció Pérez‐Benavente
JBRA assisted reproduction · 2021 · vol. 26(1) , pp. 88–104 · doi:10.5935/1518-0557.20210060 · PMID:34755503 · W3212517868
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Laparoscopic endometrioma surgery significantly decreases short, medium, and long-term anti-Müllerian hormone levels compared to baseline, with greater reductions observed in bilateral or larger endometriomas.

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Abstract

OBJECTIVE: This study aimed to assess the effect of endometrioma surgery on ovarian reserve by measuring anti-Müllerian hormone (AMH) levels. METHODS: This systematic review and meta-analysis included observational studies and randomized clinical trials published in English referenced in MEDLINE, SCOPUS and Cochrane (1982-2019). We included studies that reported AMH levels in the pre and post-operative period of patients undergoing laparoscopic surgery for endometrioma. Preoperative AMH was defined as the baseline AMH; short term AMH was measured no later than a month after surgery; medium term AMH was measured between one and six months after surgery; and long-term AMH was measured six or more months after surgery. RESULTS: Thirty-six studies met the inclusion criteria. A significant decrease was observed in short, medium and long-term post-operative AMH levels when compared with baseline AMH. However, there were no differences between short and long-term post-operative AMH levels, suggesting a non-significant recovery after one year of follow-up. A significant decrease in post-operative AMH was observed in bilateral endometriomas compared with unilateral cases. In addition, patients with endometriomas presented a significant decline in post-operative AMH compared with patients with other benign ovarian conditions. The decrease in post-operative AMH was significantly greater in bilateral cystectomy when compared with vaporization with bipolar energy or laser. We also observed a greater decrease in post-operative AMH with bipolar energy hemostasis compared with suture and hemostatic agents. These results should be taken with caution due to the high heterogeneity of the studies analyzed. CONCLUSIONS: Endometrioma surgery has a deleterious effect on short, medium, and long-term post-operative AMH levels. Bilateral endometriomas and endometriomas greater than 7 cm have been associated with greater decreases in AMH. The mechanical resection of healthy tissue and the inflammatory damage on the ovarian cortex might explain the diminishing of ovarian reserve.

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Condition tags

mesh:D004715endometrioma

MeSH descriptors

Endometriosis Endometriosis Laparoscopy Ovarian Diseases Ovarian Reserve Anti-Mullerian Hormone Female Humans Observational Studies as Topic

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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