Risk Factors for Anti Mullerian Hormone Decline after Laparoscopic Excision of Endometrioma: A Prospective Study

Laparoscopic excision of ovarian endometrioma is believed to decrease the ovarian reserve, but the riskfactors of declining ovarian reserve are not well studied. This study aimed to determine the risk factors of anti mullerianhormone (AMH) decline after laparoscopic surgery of endometrioma. This prospective study was recruited in Yas and Arash Hospitals affiliated to Tehran Universityof Medical Sciences from 2020 to 2021. Women between 18-45 years with ovarian endometriomas with a diametergreater than 3 centimeters who were candidates for laparoscopy were included. AMH, luteinizing hormone (LH),and follicular stimulating hormone (FSH) as well as cancer antigen 125 (CA125) and cancer antigen 19-9 (CA19-9)were obtained and compared pre and postoperatively. Indeed, the relation of AMH decline rate and the demographic,symptoms and endometrioma characteristics were investigated either. In this study, 100 women were recruited. The mean ± SD age of the participants was 29.08 ± 4.6. AMH(P<0.000) and LH (P=0.013) declined significantly postoperatively. Whereas, no significant difference was observedbetween pre and postoperative FSH (P=0.520). AMH decline rate was 30.07 ± 2.30% and didn’t have significant relationwith the demographic characteristics, preoperative AMH, and the amount of CA125. Otherwise in the multivariateanalysys, CA125 (P=0.160) and the grade of endometriosis (P=0.05) had significant correlation with AMH decline rate. Ovarian reserve decline after laparoscopic excision of endometrioma. Otherwise, there may no specificrisk factor to predict the degree of ovarian reserve decline. Therefore, the selection of patients for laparoscopic excisionof endometrioma should be taken more cautiously as the ovarian reserve diminishes even in the patients with thelowest risks.