Effect of laparoscopic cystectomy on serum anti-mullerian hormone level in patients with diverse benign ovarian cysts

Objective: To evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with diverse benign ovarian cysts by investigating the serum anti-mullerian hormone(AMH) level before and after operation.Methods: A total of 148 patients who underwent laparoscopic cystectomy due to unilateral ovarian cyst from March 2009 to March 2011 were recruited in this retrospective analysis.All patients were divided into Endometrioma group and Non-endometrioma group by pathological types.Surgery underwent including ovarian hemostasis,but not electric coagulation.Kupperman index was recorded,and serum FSH,LH,E2 and AMH levels were measured before operation and at 1 month,3 months and 6 months follow-up visit afterwards.Ovarian volume(Vo),the peak systolic velocity(PSV)and antral follicle counts(AFC) were determined at 6-month postoperative follow-up by ultrasonography.Results: There were no significant differences between two groups in terms of Kupperman index,serum FSH,LH and E2 levels before operation and at each follow-up time.Serum AMH level was found to be higher in Non-endometrioma group than that in Endometrioma group before operation.AMH more markedly declined at postoperative 1 month,Endometrioma group was lower than Non-endometrioma group,and was recovered to a fewer extent of the preoperative level after 3 months and 6 months postoperatively.The AMH level recovered to only about 80% of the preoperative level at 6 months postoperatively.At 6 months postoperatively,Vo,PSV and AFC were found to be similar between two groups.Normal ovarian tissues were found to be more common beside cyst walls of Endometrioma than Non-endometrioma(41.67% vs.10.61%,P0.05).Conclusion: Laparoscopic cystectomy could impair the ovarian reserve to some extent in patients with ovarian cysts in the immediate future and the effects could be related with the pathological patterns.The influence seems to be more obvious in patients with endometrioma.AMH could be an available parameter for evaluating the effect.