title: Assessment of ovarian reserve after hysterectomy: Laparoscopic vs. non-laparoscopic surgery.
abstract: OBJECTIVE
  To evaluate changes of ovarian reserve after hysterectomy by comparing serum anti-Mullerian hormone (AMH) levels following laparoscopic hysterectomy (LH) to those of non-laparoscopic hysterectomy (non-LH).
  
  
  METHODS
  Prospectively, serum AMH levels were measured pre-operatively (AMH0), 7days (AMH1), 2 months (AMH2), and 6 months (AMH3) after LH (total laparoscopic hysterectomy or laparoscopy-assisted vaginal hysterectomy) and non-LH (vaginal hysterectomy or abdominal hysterectomy) in 91 premenopausal women (LH=60, non-LH=31). Changes of serum AMH levels were compared between the two groups.
  
  
  RESULTS
  AMH0 was similar between the two groups (P=0.400). Also, AMH1, AMH2, and AMH3 were not different between the two groups (P=0.333, 0.534, and 0.726). A significant decrease of serum AMH level (30% decreases from AMH0) at 7days, 2 months, and 6 months was observed in 44.4%, 34.8%, and 40% of all patients. Interestingly, the incidence of a significant decrease of serum AMH levels at postoperative 2 months was considerably higher in LH group compare to non-LH group (43.9% vs. 20.0%, P=0.042). Multivariate analysis revealed that laparoscopic hysterectomy was an independent risk factor for the significant decrease of serum AMH at postoperative 2 months (Hazard ratio 4.147, 95% confidence interval 1.139-15.097).
  
  
  CONCLUSIONS
  Laparoscopic hysterectomy, which is associated with electro-thermal vessel ligation, might have negative effect on ovarian reserve after surgery. More large-scaled, long-term follow-up study is required.
authors.affiliation: Department of Obstetrics & Gynecology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Kyonggi-do, Republic of Korea.
authors.forename: Hye-Yon
authors.initials: HY
authors.lastname: Cho
authors.affiliation: Department of Obstetrics & Gynecology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
authors.forename: Sung Taek
authors.initials: ST
authors.lastname: Park
authors.affiliation: Department of Obstetrics & Gynecology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Kyonggi-do, Republic of Korea.
authors.forename: Min Sun
authors.initials: MS
authors.lastname: Kyung
authors.affiliation: Department of Obstetrics & Gynecology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea. Electronic address: vth2000@naver.com.
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Park
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D065851:Ovarian Reserve; D011446:Prospective Studies
chemical_list: D054304:Anti-Mullerian Hormone
keywords: AMH; Hysterectomy; Ovarian reserve