Mehdizadeh Kashi Abolfazl, Chaichian Shahla, Ariana Shideh, Fazaeli Masoumeh, Moradi Yousef, Rashidi Mandana, Najmi Zahra
Endometriosis and Gynecologic Disorder Research Center, Iran University of Medical Sciences, Tehran, Iran.
Minimally Invasive Techniques Research Center in Women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Int J Gynaecol Obstet. 2017 Feb;136(2):200-204. doi: 10.1002/ijgo.12046. Epub 2016 Dec 2.
To evaluate the effects of laparoscopic cystectomy on serum anti-Müllerian hormone (AMH) level as a marker of ovarian reserve in patients with endometrioma.
A prospective observational study enrolled patients aged younger than 40 years who were referred to a tertiary center in Tehran, Iran, between January 1, 2013 and December 31, 2014 to undergo laparoscopic cystectomy for ovarian endometriomas at least 30 mm in diameter, or regardless of size for patients with infertility, dysmenorrhea, dyspareunia, or dyschezia. Baseline and 6-month post-operative AMH levels were compared.
Data from 70 patients were included in the analyses. Among patients with unilateral endometriomas, lower pre-operative AMH levels were observed in patients with endometriomas at least 50 mm in diameter (P=0.027), whereas cyst size was not associated with differences in pre-operative AMH level in patients with bilateral endometriomas (P=0.227). Across the entire study population, post-operative AMH levels were lower than the baseline (P=0.008). Greater post-operative decreases in AMH were associated with bilateral cysts compared with unilateral cysts (P=0.046), cysts being at least 50 mm in diameter among patients with unilateral cysts (P=0.028), and both cysts being at least 50 mm in diameter among patients with bilateral cysts (P=0.025).
Laparoscopic cystectomy was associated with post-operative decreases in serum AMH, particularly with bilateral involvement and endometriomas at least 50 mm in diameter.
评估腹腔镜囊肿切除术对血清抗苗勒管激素（AMH）水平的影响，AMH作为子宫内膜异位症患者卵巢储备功能的标志物。
一项前瞻性观察性研究纳入了2013年1月1日至2014年12月31日期间转诊至伊朗德黑兰一家三级中心的40岁以下患者，这些患者因直径至少30 mm的卵巢子宫内膜异位囊肿接受腹腔镜囊肿切除术，对于不孕、痛经、性交困难或排便困难的患者，囊肿大小不限。比较基线和术后6个月的AMH水平。
70例患者的数据纳入分析。在单侧子宫内膜异位症患者中，直径至少50 mm的子宫内膜异位症患者术前AMH水平较低（P=0.027），而双侧子宫内膜异位症患者囊肿大小与术前AMH水平差异无关（P=0.227）。在整个研究人群中，术后AMH水平低于基线（P=0.008）。与单侧囊肿相比，双侧囊肿术后AMH下降幅度更大（P=0.046），单侧囊肿患者中直径至少50 mm的囊肿（P=0.028），以及双侧囊肿患者中两个囊肿直径均至少50 mm（P=0.025）。
腹腔镜囊肿切除术与术后血清AMH下降有关，尤其是双侧受累以及直径至少50 mm的子宫内膜异位囊肿。
