title: Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimüllerian hormone levels.
abstract: OBJECTIVE
  To investigate the effect of laparoscopic endometrioma stripping on serum antimüllerian hormone (AMH) and the correlation between the clinicopathologic factors.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Sixty-five women with endometriomas.
  
  
  METHODS
  All patients underwent laparoscopic cystectomy. Serum AMH, FSH, LH, E(2), and antral follicle count (AFC) were measured preoperatively, at 6 weeks, and at 6 months postoperatively. Specimens were analyzed histopathologically.
  
  
  METHODS
  The primary end point was to assess the ovarian reserve damage based on alterations of AMH and the secondary end point was to detect the changes in FSH, LH, E(2), and AFC.
  
  
  RESULTS
  Serum AMH decreased significantly at the sixth month (61%) postoperatively. The FSH level increased significantly at the sixth week, but returned to normal at the sixth month. The AFC increased significantly at the sixth week and at the sixth month. The AMH level decrease was more evident in patients with the cyst <5 cm (65.7% vs. 41.3%). The AMH decrease was more in bilateral compared with unilateral endometriomas (67% versus 57%, respectively). No correlation was detected between the histopathologic analyses and tAMH level. Initially the AMH level was the only independent factor affecting the AMH decrease (odds ratio, 3.68; 95% confidence interval 1.66-8.14).
  
  
  CONCLUSIONS
  Laparoscopic cystectomy of ovarian endometriomas causes a significant and progressive decline in serum AMH levels.
authors.affiliation: Department of Obstetrics and Gynecology, Kayseri Develi General Hospital, Turkey.
authors.forename: Hale Goksever
authors.initials: HG
authors.lastname: Celik
authors.forename: Erbil
authors.initials: E
authors.lastname: Dogan
authors.forename: Emre
authors.initials: E
authors.lastname: Okyay
authors.forename: Cagnur
authors.initials: C
authors.lastname: Ulukus
authors.forename: Bahadir
authors.initials: B
authors.lastname: Saatli
authors.forename: Sezer
authors.initials: S
authors.lastname: Uysal
authors.forename: Meral
authors.initials: M
authors.lastname: Koyuncuoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004715:Endometriosis / Q000601:surgery*; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility / Q000502:physiology*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects*; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D006080:Ovarian Follicle / Q000473:pathology / Q000502:physiology*; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D004958:Estradiol; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone