Effect of laparoscopic endometrioma cystectomy on anti-Müllerian hormone (AMH) levels

Yu Wang, Xiangyan Ruan, Dan Lu, Jie Sheng, Alfred O Mueck
Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology · 2019 · vol. 35(6) , pp. 494–497 · doi:10.1080/09513590.2018.1549220 · PMID:30732484 · W2911525673
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Laparoscopic endometrioma cystectomy led to decreased anti-Müllerian hormone (AMH) levels after 12 months in patients with bilateral, larger cysts, and stage IV endometriosis, with suturing potentially protecting against AMH decline.

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Abstract

Objective: To investigate temporary or long-term changes of AMH after laparoscopic endometrioma cystectomy and its dependency on characteristics of endometriomas.Methods: One hundred and seventy-one women, open-labeled prospective study; five groups divided according age ≤/> 35, uni-/bilateral, cyst ≤/> 7 cm, coagulation/suture surgery, stage III/IV; between- and within-group analyses after 1, 3, 6, and 12 months.Results: After 12 months, compared to pretreament, AMH decreased significantly for patients with bilateral cysts, cyst size >7 cm and endometriosis stage IV. In the between-group analysis all comparisons were significant, with exception of the surgery type. However, this was different performing the multiple linear regression analysis suggesting lower postoperative decrease using suturing technique. This analysis also showed higher age at pretreatment and bilateral cysts as risk factor for AMH decline.Conclusions: Effects of endometrioma cystectomy on AMH are dependent on characteristics of the endometrioma, showing long-term a decrease in patients with larger, bilateral cysts and in stage IV endometriosis, but only short-time decrease in smaller, unilateral cysts and stage III which sometimes also can fully recover in AMH production within one year. In our study suture compared to coagulation surgery was protective, i.e. may lead to lower postoperative AMH decline.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Anti-Mullerian Hormone Endometriosis Gynecologic Surgical Procedures Laparoscopy Ovarian Cysts Ovarian Diseases Adult Anti-Mullerian Hormone Endometriosis Endometriosis Female Gynecologic Surgical Procedures Humans Laparoscopy Ovarian Cysts Ovarian Cysts Ovarian Diseases Ovarian Diseases Ovarian Reserve Ovarian Reserve

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