Evaluation of Serum AMH, INHB Combined with Basic FSH on Ovarian Reserve Function after Laparoscopic Ovarian Endometriosis Cystectomy

Yan Tang, Yanning Li
Frontiers in surgery · 2022 · vol. 9 , pp. 906020 · doi:10.3389/fsurg.2022.906020 · PMID:35662819 · PMC9158433 · W4280598638
article OA: gold CC0 ⤵ 13 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Serum AMH, INHB, and bFSH levels were measured post-cystectomy to assess ovarian reserve, with their combined use showing high diagnostic value for diminished ovarian reserve and premature ovarian failure.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This study evaluated serum anti-Mullerian hormone (AMH), inhibin B (INHB), and basal FSH (bFSH), alongside antral follicle count (AFC), in 124 women undergoing laparoscopic ovarian endometrioma cystectomy, measuring markers preoperatively and again on postoperative menses days and classifying outcomes as normal ovarian reserve, diminished ovarian reserve (DOR), or premature ovarian failure (POF). Postoperatively, AMH, INHB, and AFC decreased in the DOR and POF groups while bFSH increased, and all three marker levels discriminated POF from DOR (with the opposite direction for bFSH); Pearson analyses showed AMH and INHB positively correlated with AFC and inversely correlated with bFSH, and ROC analyses found the combined AMH+INHB+bFSH test had higher diagnostic performance (AUC 0.940) than each marker alone. The paper’s explicit limitations include use of a single-center cohort with specific eligibility criteria and postoperative classification based on their chosen bFSH cutoffs and AFC thresholds, without reporting longer-term outcomes. This paper is centrally about endometriosis — it examines how postoperative ovarian reserve biomarkers change after laparoscopic endometrioma (ovarian endometriosis) cystectomy.

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Abstract

OBJECTIVE: The value of serum AMH, INHB, and bFSH levels in assessing postoperative ovarian reserve function was analyzed by measuring serum anti-Mullerian hormone (AMH), inhibin B (INHB), and basal follicle-stimulating hormone (bFSH) levels in patients after laparoscopic cystectomy for endometrioma. METHODS: From June 2019 to December 2021, 124 patients underwent laparoscopic cystectomy for endometrioma in our hospital were selected, and the serum AMH, INHB, bFSH level, antral follicle count (AFC) of all patients before and after operation were detected and compared. According to the results of postoperative testing, all the patients were divided into normal group (n = 86), diminished ovarian reserve (DOR) group (n = 27), and premature ovarian failure (POF) group (n = 11). Pearson correlation model and subject operating characteristic curve (ROC) were used to analyze the correlation and diagnostic value of serum AMH, INHB and bFSH levels with postoperative ovarian reserve function, respectively. RESULTS: After operation, the levels of serum AMH, INHB and AFC in the DOR group and POF group decreased compared with those before the operation, and the serum bFSH levels increased (p < 0.05). After operation, the levels of serum AMH, INHB and AFC in DOR group and POF group were lower than those in normal group,and the serum bFSH levels were higher than the normal group; the levels of serum AMH, INHB and AFC in POF group were lower than those in DOR group, and the serum bFSH levels were higher than the DOR group (p < 0.05). Pearson analysis showed that serum AMH and INHB levels were negatively correlated with bFSH, and positively correlated with the number of AFC, the serum bFSH level was negatively correlated with the number of AFC (p < 0.05). The diagnostic values of serum AMH, bFSH, INHB and the combination of the three tests for postoperative abnormal ovarian reserve function were 0.866 (95% CI, 0.801-0.923), 0.810 (95% CI, 0.730-0.890), 0.774 (95% CI, 0.687-0.860) and 0.940 (95% CI, 0.900-0.981), respectively. CONCLUSION: Serum AMH and INHB levels decreased and bFSH levels increased in patients after laparoscopic cystectomy for endometrioma, both of which were closely related to postoperative ovarian reserve function, and both could evaluate ovarian reserve function after ovarian cyst debulking, and the combined test could significantly improve the detection rate.

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endometriosisendometrioma

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