Anti-Müllerian hormone reduction after ovarian cyst surgery is dependent on the histological cyst type and preoperative anti-Müllerian hormone levels.

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.

• Authors: Tekla Lind, Margareta Hammarström, Claudia Lampic, Kenny Rodriguez-Wallberg
• Journal: Acta obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 94 Issue 2 Pg. 183-90 (Feb 2015) ISSN: 1600-0412 [Electronic] United States
• PMID: 25287421 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd. on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Chemical References

• Anti-Mullerian Hormone

Topics

• Adolescent
• Adult
• Anti-Mullerian Hormone (blood)
• Endometriosis (blood, physiopathology)
• Female
• Humans
• Multivariate Analysis
• Ovarian Cysts (blood, pathology, physiopathology, surgery)
• Ovary (physiopathology)
• Postoperative Period
• Preoperative Period
• Prospective Studies
• Young Adult