Evaluation of antimullerian hormone levels before and after laparoscopic management of endometriosis

Abstract

BACKGROUND: Serum antimullerian hormone (AMH) proposed to be a reliable marker of ovarian reserve; the aim of this study was to evaluate the influence and value of laparoscopic management in endometriosis as measured by serum AMH levels. MATERIALS AND METHODS: In this cross-sectional study, 33 infertile patients who referred to fertility - Infertility Center of Isfahan - with different stages of endometriosis managed by diagnostic operative laparoscopy and serum AMH levels were measured pre and one month postoperative laparoscopy. Main outcome measures were serum AMH levels in correlation with the type of infertility, stage of endometriosis, and type of surgery in infertile patients. RESULTS: 33 infertile patients enrolled in the study with mean age 28.9 +/- 5 years, and thus did not show a significant difference. Mean serum AMH levels was 4.23 +/- 3.75 ng/ml and 2.2 +/- 2.47 ng/ml, respectively, in primary and secondary infertility groups before and one month after laparoscopy, which shows a significant difference (P < 0.001). Median AMH level changes in Cauterization (0.67 +/- 0.76 ng/ml), endometrioma excision 2 +/- 0.6 ng/ml, both 2.18 +/- 0.81 ng/ml and shows no significant differences. Mean serum AMH levels were definitely decreased in minimal/mild and severe stage endometriosis before and 1 month after laparoscopy, (1.84 +/- 2.06 ng/ml and 2.18 +/- 3.45 ng/ml), respectively. Also serum AMH according to ovarian appearance and evolvement showed no significant differences after laparoscopy: (5.5 +/- 1.4 ng/ml and 2.76 +/- 0.96 ng/ml) and (3.37 +/- 2.2 ng/ml and 1.84 +/- 1.5 ng/ml). CONCLUSION: Serum AMH levels clearly decreased 1 month after operative laparoscopy.