5.FACTORS RELATED TO SERUM ANTI-MULLERIAN HORMONE LEVELS CHANGES AT 3 MONTHS AFTER LAPAROSCOPIC ENDOMETRIOMA CYSTECTOMY

Nguyen Thi Thu Ha1,2, Nguyen Duy Anh2,3,4, Nguyen Duc Hinh4
1 . National of Hospital Obstetrics & Gynecology
2 Hanoi Obstetrics & Gynecology Hospital
3 National of Hospital Obstetrics & Gynecology
4 Hanoi Medical University

Main Article Content

Abstract

Objective: To evaluate factors related to serum anti-mullerian hormone (AMH) levels changes at 3 months after laparoscopic endometrioma cystectomy.


Materials and method: A prospective longitudinal study was conducted at Hanoi Obstetrics and Gynecology Hospital from 1/2015 to 10/2016. We recruited 104 women aged 18-40, with ovarian endometriosis, which was confirm in post-operative pathology, and underwent laparoscopic endometrioma cystectomy. The excluded criteria consist of post-menopause, polycystic ovarian syndrome, previous ovarian surgery, combined with other ovarian disorders, hormone disorders, being pregnant during study period and refusal participation. Participant’s characteristics, endometriomas and surgery was collected, and 3-month post-operation.


Results: The mean age of participants was 29 years. At 3-month postoperation, the mean AMH level decreased significantly compared to preoperatoin, from 4.47 ng/ml to 1.96 ng/ml (p < 0.001). The magnitude of AMH level decline were 48.7 ± 34.1%. The AMH levels decreased more in women < 30 years old (55.5% vs 37% in > 30 years old), bilateral cyst (72% vs 40.5% in unilateral cyst), cyst diameter > 6 cm when cysts are on one ovary (52% vs 36.2% in cysts < 6 cm) and cyst at stage 4 according to rASRM (59.3% vs 39.6% in stage 3). The changes of AMH levels was independent to BMI and CA125 levels.


Conclusions: Factors related to AMH level decreasing at 3 months after laparoscopic endometrioma cystectomy included young women, and bilateral, large, 4-stage according to rASRM cysts.

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References

[1] Johnson N.P, Hummelshoj L, Consensus on current management of endometriosis, Human reproduction (Oxford, England) , 2013, 28 (6): 1552-68.
[2] Kuroda M, Kuroda K, Arakawa A, Fukumura Y, Kitade M, Kikuchi I et al, Histological assessment of impact of ovarian endometrioma and laparoscopic cystectomy on ovarian reserve, The journal of obstetrics and gynaecology research, 2012, 38 (9): 1187-93.
[3] Kalaitzopoulos D.R, Samartzis N, Kolovos G.N, Mareti E, Samartzis E.P, Eberhard M et al, Treatment of endometriosis: a review with comparison of 8 guidelines, BMC women's health, 2021, 21 (1): 397.
[4] Arce J.C, La Marca A, Mirner Klein B, Nyboe Andersen A, Fleming R, Antimüllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients, Fertility and sterility, 2013, 99 (6): 1644-53.
[5] Raffi F, Metwally M, Amer S, The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis, The Journal of clinical endocrinology and metabolism, 2012, 97 (9): 3146-54.
[6] Lee D.Y, Young Kim N, Jae Kim M, Yoon B.K, Choi D, Effects of laparoscopic surgery on serum anti-Müllerian hormone levels in reproductive-aged women with endometrioma, Gynecological endocrinology: the official Journal of the International Society of Gynecological Endocrinology, 2011, 27 (10): 733-6.
[7] Ercan C.M, Duru N.K, Karasahin K.E, Coksuer H, Dede M, Baser I, Ultrasonographic evaluation and anti-mullerian hormone levels after laparoscopic stripping of unilateral endometriomas, European Journal of obstetrics, gynecology, and reproductive biology, 2011, 158 (2): 280-4.
[8] Chang H.J, Han S.H, Lee J.R, Jee B.C, Lee B.I, Suh C.S et al, Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels, Fertility and sterility, 2010, 94 (1): 343-9.
[9] Kwon S.K, Kim S.H, Yun S.C, Kim D.Y, Chae H.D, Kim C.H et al, Decline of serum antimüllerian hormone levels after laparoscopic ovarian cystectomy in endometrioma and other benign cysts: a prospective cohort study, Fertility and sterility, 2014, 101 (2): 435-41.
[10] Fleming R, Kelsey T.W, Anderson R.A, Wallace W.H, Nelson S.M, Interpreting human follicular recruitment and antimüllerian hormone concentrations throughout life, Fertility and sterility, 2012, 98 (5): 1097-102.
[11] Chen Y, Pei H, Chang Y, Chen M, Wang H, Xie H et al, The impact of endometrioma and laparoscopic cystectomy on ovarian reserve and the exploration of related factors assessed by serum anti-Müllerian hormone: a prospective cohort study, Journal of ovarian research, 2014, 7: 108.