title: Comparing the effect of laparoscopic supracervical and total hysterectomy for uterine fibroids on ovarian reserve by assessing serum anti-mullerian hormone levels: a prospective cohort study.
abstract: OBJECTIVE
  To compare prospectively the impact on ovarian reserve of total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH) for treating uterine fibroids as measured by serum anti-Mullerian hormone (AMH) levels.
  
  
  METHODS
  In this prospective study, 83 patients (aged 38-47 years) with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43) with conservation of both ovaries. Of these, 33 patients from the TLH group and 34 patients from the LSH group completed follow-up (Canadian Task Force Classification II-2).
  
  
  METHODS
  Hospital.
  
  
  METHODS
  Eighty-three patients aged 38-47 years.
  
  
  METHODS
  Patients with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43).
  
  
  RESULTS
  Changes in ovarian reserve were investigated by measuring serum levels of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) before surgery and at 1 month and 4 months after surgery. In both the TLH and LSH groups, serum AMH levels were significantly decreased at 1 month and 4 months postsurgery compared with baseline levels (p < .001). The decrease in serum AMH levels was greater in the TLH group than in the LSH group at 1 month postsurgery, but the difference was not statistically significant. The decrease in serum AMH levels was significantly greater in the LSH group at 4 months postsurgery (p < .001). In both groups, no significant changes in serum FSH, LH, or E2 levels were seen at 1 month or 4 months (p > .05).
  
  
  CONCLUSIONS
  Serum AMH levels were decreased significantly at 4 months after hysterectomy, with a greater decrease in the TLH group compared with the LSH group, indicating the prognostic importance of serum AMH level in reflecting ovarian reserve in patients undergoing hysterectomy.
authors: Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China; Department of Gynecology, Maternal and Child Health Hospital of Wuxi, Wuxi, China.
authors: Hua
authors: H
authors: Yuan
authors: Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
authors: Chunyan
authors: C
authors: Wang
authors: Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
authors: Dongjie
authors: D
authors: Wang
authors: Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. Electronic address: wangyifengmedical@126.com.
authors: Yifeng
authors: Y
authors: Wang
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery*; D007986:Luteinizing Hormone / Q000097:blood*; D008875:Middle Aged; D065851:Ovarian Reserve; D010053:Ovary; D011184:Postoperative Period; D011446:Prospective Studies
chemical_list: D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: Anti-Mullerian hormone; Laparoscopic surgery; Ovarian reserve; Supracervical hysterectomy; Total hysterectomy