The effect of total abdominal hysterectomy on serum anti-Mullerian hormone levels: a pilot study

Objective To evaluate the effect of hysterectomy on levels of serum anti-Mullerian hormone (AMH), an indicator of ovarian reserve. Method Twenty-two premenopausal women between 40 and 50 years of age who underwent total abdominal hysterectomy for uterine leiomyoma were enrolled to the patient group and unaffected women in a similar age range constituted the control group. Samples were collected preoperatively and at the 4th month postoperatively from the patients and two times at 4 months apart from the controls. Serum AMH levels were detected with enzyme-linked immunosorbent assay and compared within each group and between groups. Results Baseline serum AMH values were similar (1.46 +/- 2.02 ng/ml for the hysterectomy group and 1.53 +/- 1.82 ng/ml for the control group, p = 0.73). Serum AMH levels at month 4 decreased to 0.62 +/- 0.9 ng/ml and 1.26 +/- 1.78 ng/ml for hysterectomy patients and controls, respectively (p = 0.001 and <0.001, respectively). Although the percentage median decrease was higher in hysterectomized women (58.9% vs. 28.5%), this was statistically insignificant (p = 0.26). Conclusion Although not statistically significant, our study demonstrated that total abdominal hysterectomy causes 30% more loss of ovarian reserve in addition to the effects of aging. Further research on larger populations is needed to confirm our results and to apply them in clinical practice.