Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels.
OBJECTIVE
To evaluate the ovarian reserve changes after laparoscopic cystectomy, we prospectively evaluated pre- and postoperative serum anti-Müllerian hormone (AMH) level, and ovarian volumes.


METHODS
Prospective longitudinal study.


METHODS
University Hospital.


METHODS
Twenty women with benign ovarian masses participated; endometrioma [13], mature teratoma [6], and mucinous cystadenoma [1]. Seven patients had bilateral ovarian masses.


METHODS
All patients had undergone laparoscopic ovarian cystectomy. Serum AMH levels were serially measured: preoperative, 1 week, 1 month, and 3 months after operation. Volumes of total ovary and ovarian mass were measured by 3D ultrasonography before operation.


METHODS
Postoperative serum AMH level and ovarian volume.


RESULTS
Median AMH level was 2.23 ng/mL (95% confidence interval [CI] 1.35-3.41 ng/mL) before operation, but reduced to 0.67 ng/mL (95% CI 0.44-1.70 ng/mL) at the first week postoperatively and then increased to 1.14 ng/mL (95% CI 0.79-2.36 ng/mL) in the first month and 1.50 ng/mL (95% CI 0.58-3.26 ng/mL) in the third month. The serum AMH level after 3 months postoperatively was recovered to about 65% of the preoperative level. The serum AMH level at postoperative 1 week was more decreased in endometrioma compared with nonendometrioma (33.9% vs. 69.2% of preoperative level), and in bilateral group compared with unilateral group (16.9% vs. 62.9%).


CONCLUSIONS
This study suggests that ovarian reserve could be reduced after laparoscopic cystectomy; however, it could be restored thereafter up to 3 months postoperative in reproductive women.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul, South Korea.
Hye Jin
HJ
Chang
Sang Hoon
SH
Han
Jung Ryeol
JR
Lee
Byung Chul
BC
Jee
Byoung Ick
BI
Lee
Chang Suk
CS
Suh
Seok Hyun
SH
Kim
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000037:antagonists & inhibitors / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008137:Longitudinal Studies; D010048:Ovarian Cysts / Q000097:blood* / Q000000981:diagnostic imaging* / Q000601:surgery; D010053:Ovary / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography
D054304:Anti-Mullerian Hormone