卵巢子宮內膜異位瘤切除後AMH 下降

腹腔鏡卵巢子宮內膜異位瘤切除後，造成卵巢功能下降，

AMH 下降(3.8->2)，FSH上升

http://www.ncbi.nlm.nih.gov/pubmed/24269044



Fertil Steril. 2013 Nov 20. pii: S0015-0282(13)03165-8. doi: 10.1016/j.fertnstert.2013.10.019.  

The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas.

OBJECTIVE:

To evaluate the effects of laparoscopic cystectomy on ovarian reserve in patients with endometriomas.

DESIGN:

Prospective study.

SETTING:

Private and university hospitals.

PATIENT(S):

A total of 193 patients with endometriomas undergoing laparoscopic cyctectomy.

INTERVENTION(S):

Serum levels of antimüllerian hormone (AMH), FSH, and E2, as well as antral follicle count (AFC) were measured preoperatively and 1 week, 3 and 9 months postoperatively for AMH, and 3 months for other values.

MAIN OUTCOME MEASURE(S):

Ovarian reserve based on the comparison of AMH alterations. The secondary end points are changes in FSH, E2, and AFC.

RESULT(S):

Serum AMH level decreased significantly from the baseline (3.86 ± 3.58 ng/mL) to 1 week (1.66 ± 1.92 ng/mL), 3 months (2.06 ± 2.5 ng/mL), and 9 months (1.77 ± 1.76 ng/mL) postoperatively. Those patients with bilateral endometriomas had significantly lower levels of AMH, 1 week, 3 and 9 months after operation. Also, patients older than 38 years had lower postoperative AMH levels. The FSH levels increased significantly from baseline to 3 months postoperatively. The AFC level increased significantly from baseline to 3 months after operation.

CONCLUSION(S):

The AMH level decreased and the FSH level increased after laparoscopic cystectomy for endometriomas, especially in older patients and those with bilateral cysts.