Decline of serum antimullerian hormone levels after laparoscopic ovarian cystectomy in endometrioma and other benign cysts: a prospective cohort study

Objective: To identify the most important factor in predicting ovarian reserve after laparoscopic ovarian cystectomy and to evaluate whether there is any difference in the postoperative decline of ovarian reserve between women with endometrioma and those with other benign ovarian cysts. Design: Prospective cohort study. Setting: University hospital. Patient(s): A total of 100 women who had undergone laparoscopic ovarian cystectomy for endometrioma (n = 68) or other benign ovarian cysts (n = 32). Intervention(s): Serum antimullerian hormone (AMH) levels measured by enzyme immunoassay preoperatively and at 3 months after surgery. Main Outcome Measure(s): Rate of AMH decline after surgery and follicle numbers retained in cystectomy specimens. Result(s): Serum AMH levels were obviously decreased at 3 months after the surgery (4.97 +/- 2.83 vs. 3.33 +/- 2.08 ng/mL, mean +/- standard deviation). Adjusting for several parameters, we could see that bilaterality of the ovarian cyst was the only significant factor in predicting the rate of postoperative decline of AMH levels. The rate of AMH decline did not differ between the endometrioma group and the other benign ovarian cyst group. Conclusion(s): Bilaterality of the ovarian cyst is the only significant factor in predicting the rate of decline of AMH level after laparoscopic ovarian cystectomy. The rate of decline of AMH levels after surgery was similar between the endometrioma group and the other benign ovarian cyst group. (C) 2014 by American Society for Reproductive Medicine.