Open AccessAnti‐Müllerian hormone reduction after ovarian cyst surgery is dependent on the histological cyst type and preoperative anti‐Müllerian hormone levels
Author(s) -
Lind Tekla,
Hammarström Margareta,
Lampic Claudia,
RodriguezWallberg Kenny
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12526
Subject(s) - medicine , anti müllerian hormone , enucleation , cyst , odds ratio , prospective cohort study , hormone , ovarian reserve , ovarian cyst , gynecology , surgery , pregnancy , infertility , biology , genetics
Abstract Objective To investigate changes in serum anti‐Müllerian hormone ( AMH ) concentrations following ovarian cyst surgery, and predictors of these changes. Design Prospective cohort study with follow up at 3 and 6 months. Setting University hospital. Population Women of reproductive age scheduled for ovarian cyst surgery. Methods Women were recruited between March 2011 and March 2012 ( n = 75). Serum AMH concentrations were measured preoperatively and at 3 and 6 months postoperatively. Main outcome measures Changes in AMH after surgery and predictors for these changes. Results After surgery, median AMH levels decreased significantly from 2.7 μg/L (0.2–16.9) to 1.6 μg/L (0.2–9.9) at 3 months and were still low, 1.6 μg/L (0.2–8.3) at 6 months (both p < 0.001). In patients with unilateral cysts, a significant and more rapid AMH decrease was seen after enucleation of endometriomas ( n = 19) vs. dermoid cysts ( n = 22) ( p = 0.010). The reduction was long‐lasting at 6 months. In a multivariate regression analysis, a higher baseline AMH concentration was predictive of AMH reduction at 3 [odds ratio ( OR ) 1.9, 95% CI 1.1–3.1] and 6 months postoperatively ( OR 2.5, 95% CI 1.2–5.2). Women with normal or elevated baseline AMH presented with a significant reduction of −23% and −43% at 3 and 6 months, respectively, whereas women with low or very low AMH had minimal or no changes over time. Patient's age, cyst size, duration of surgery or intraoperative bleeding were not predictive of a postoperative AMH decrease. Conclusions Reduction of AMH was of greater magnitude and longer duration after enucleation of endometriomas and in women with normal and high preoperative AMH levels.