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

Acta Obstetricia et Gynecologica Scandinavica - Tập 94 Số 2 - Trang 183-190 - 2015
Tekla Lind1, Margareta Hammarström2, Claudia Lampic3, Kenny A. Rodriguez‐Wallberg1,4
1Department of Clinical Science, Intervention and Technology (CLINTEC) Section for Obstetrics and Gynecology Karolinska Institute Stockholm Sweden
2Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
3Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
4Department of Obstetrics and Gynecology Fertility Unit Karolinska University Hospital Stockholm Sweden

Tóm tắt

AbstractObjectiveTo investigate changes in serum anti‐Müllerian hormone (AMH) concentrations following ovarian cyst surgery, and predictors of these changes.DesignProspective cohort study with follow up at 3 and 6 months.SettingUniversity hospital.PopulationWomen of reproductive age scheduled for ovarian cyst surgery.MethodsWomen 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 measuresChanges in AMH after surgery and predictors for these changes.ResultsAfter 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.ConclusionsReduction of AMH was of greater magnitude and longer duration after enucleation of endometriomas and in women with normal and high preoperative AMH levels.

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Acta Obstetricia et Gynecologica Scandinavica

Tập 94 Số 2

183-190

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