Serum anti-mullerian hormone in reproductive aged women with benign ovarian cysts.

OBJECTIVE

There is consistent evidence demonstrating that laparoscopic removal of benign ovarian cysts significantly damages the ovarian reserve. In contrast, the pre-operative impact of these cysts on the ovarian reserve is yet controversial. To elucidate this aspect, we set up a cross-sectional study in reproductive age women with and without benign ovarian cysts.

STUDY DESIGN

Inclusion criteria were as follow: (1) Age 18-40 years, (2) regular menstrual cycles, (3) Indication to laparoscopic surgery. Eligible women donated a blood sample for anti-Mullerian hormone (AMH) testing. Women who were diagnosed at surgery with concomitant endometriotic and non-endometriotic ovarian cysts, deep infiltrating peritoneal endometriosis or malignancies were subsequently excluded.

RESULTS

Diagnoses of the included women were as follows: ovarian endometriomas (n=122), non-endometriotic ovarian cysts (n=50) and non-ovarian diagnoses (n=113). Serum AMH in the three groups did not significantly differ. The median (Interquartile range-IQR) was 1.8 (0.8-3.1), 2.0 (0.8-3.9) and 1.9 (0.9-3.3) ng/ml, respectively (p=0.60). The analyses were repeated grouping women into those with bilateral cysts (n=54), unilateral cysts (n=118) and intact gonads (n=113). Women with bilateral lesions were found to have significantly lower levels of serum AMH. The median (IQR) serum AMH in the three groups was 1.3 (0.5-2.5), 2.0 (1.1-3.6) and 1.9 (0.9-3.3) ng/ml, respectively (p=0.019). We failed to demonstrate any correlation between serum AMH and the dimension of the ovarian cysts.

CONCLUSIONS

Serum AMH is lower in women with bilateral ovarian cysts and this does not appear to be related to the histology or dimension of the lesions.