title: 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.
  
  
  METHODS
  Prospective cohort study with follow up at 3 and 6 months.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  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.affiliation: Department of Clinical Science, Intervention and Technology (CLINTEC), Section for Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Tekla
authors.initials: T
authors.lastname: Lind
authors.forename: Margareta
authors.initials: M
authors.lastname: Hammarström
authors.forename: Claudia
authors.initials: C
authors.lastname: Lampic
authors.forename: Kenny
authors.initials: K
authors.lastname: Rodriguez-Wallberg
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D004715:Endometriosis / Q000097:blood / Q000503:physiopathology; D005260:Female; D006801:Humans; D015999:Multivariate Analysis; D010048:Ovarian Cysts / Q000097:blood* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010053:Ovary / Q000503:physiopathology; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Anti-Müllerian hormone; cyst enucleation; ovarian cyst surgery; ovarian reserve; prospective follow up