Changes in serum antimüllerian hormone levels in patients 6 and 12 months after endometrioma stripping surgery

To investigate the impact of laparoscopic endometrioma cystectomy on the ovarian reserve and to identify the most important factors that predict the ovarian reserve in patients with endometriomas.

Prospective study.

Endoscopy unit of a general hospital.

Fifty-four patients with unilateral (n = 37) and bilateral endometriomas (n = 17).

The serum antimüllerian hormone (AMH) concentration was assessed before surgery and at 6 and 12 months after surgery.

The primary outcome was the damage to the ovarian reserve, as assessed by the serum AMH concentration. Secondary end points were the persistence or recovery of ovarian damage after 1 year.

AMH concentrations decreased after the laparoscopic excision of cystic ovarian endometriomas. Before surgery and at 6 and 12 months after surgery, the concentrations were, respectively 3.07, 1.29, and 1.46 ng/mL. In the unilateral group, the median AMH levels were 3.31, 1.43, and 1.72 ng/mL, and in the bilateral group the levels were 2.55, 0.98, and 0.89 ng/mL. The serum AMH concentrations thus decreased by 53.27 ± 38.2% and 49.43 ± 38.3% at 6 and 12 months after cystectomy, respectively.

In patients with endometriomas, the decrease in ovarian reserve occurs immediately after the excision of the endometrioma. Significant predictors of AMH values at 6 and 12 months after surgery include the baseline AMH level, patient age, and bilateral endometriomas.