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Does large endometrioma per se increase AMH level?

Johnny S Younis1, Scott M Nelson2

  • 1Reproductive Medicine, Department of Obstetrics and Gynecology, Baruch-Padeh Medical Center, Poriya 15208, Israel; Azrieili Faculty of Medicine in Galilee, Safed, Bar-Ilan University, Israel.

Reproductive Biomedicine Online
|February 15, 2021
PubMed
Summary
This summary is machine-generated.

Ovarian reserve appraisal in women with endometriosis and endometrioma is challenging. Recent studies suggest high anti-Müllerian hormone (AMH) levels with large endometriomas, contradicting established research and warranting caution.

Keywords:
Anti-Müllerian hormoneEndometriomaEndometriosisEndometriotic cystectomyOvarian reserve appraisal

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Area of Science:

  • Reproductive Endocrinology
  • Gynecology

Background:

  • Ovarian reserve appraisal in women with endometriosis, particularly endometrioma, poses significant clinical challenges.
  • Key questions involve endometrioma's impact on ovarian reserve, surgical effects, and biomarker accuracy (anti-Müllerian hormone [AMH], antral follicle count).
  • Traditionally, endometrioma growth was linked to reduced ovarian reserve and serum AMH levels due to ovarian tissue damage.

Purpose of the Study:

  • To critically evaluate recent findings suggesting increased AMH levels in women with large endometriomas.
  • To discuss the clinical implications and biological plausibility of these surprising observations.
  • To emphasize the need for caution and further research before altering clinical practice.

Main Methods:

  • Commentary and critical review of existing literature and recent studies.
  • Analysis of the relationship between endometrioma size and serum AMH levels.
  • Discussion of the biological plausibility and clinical relevance of reported findings.

Main Results:

  • Recent studies report elevated AMH levels in women with large endometriomas, contrary to established understanding.
  • These findings, if validated, challenge the conventional view of endometrioma's effect on ovarian reserve.
  • The reported association between large endometriomas and high AMH levels appears biologically implausible based on current research.

Conclusions:

  • Urgent replication of studies reporting increased AMH in women with large endometriomas is recommended.
  • Caution is advised against immediate changes in clinical practice based on these preliminary and potentially contradictory findings.
  • Further research is essential to reconcile these new observations with the extensive body of existing evidence on endometriosis and ovarian reserve.