This prospective study had the objective to compare anti-Müllerian hormone (AMH) serum levels among women with endometriomas and those with other benign ovarian cysts and verify a possible correlation between the AMH post-operative decline and the achievement of pregnancy. The study included 57 women undergoing laparoscopic surgery. Serum levels of AMH were measured preoperatively and at 6 and 12 months postoperatively. AMH serum levels decreased in both endometriomas and other benign cysts, but significant recovery was reported only in endometriomas (p = .029). Through an interview, information on reproductive outcome was obtained. The secondary endpoint was to identify other predictors of spontaneous pregnancy onset. After surgery 27 women attempted to conceive. At 18-months follow-up, 12 of them got pregnant, with a live birth of 37%. We did not record statistically significant differences in reproductive outcome between women with AMH serum levels lower and higher than 1.1 ng/ml (41.7 and 53.3% respectively). There was no statistically significant difference in AMH serum levels between pregnant and non-pregnant women, neither before nor after surgery. AMH did not appear to have a predictive role on reproductive outcome.

Anti-Müllerian hormone (AMH) is produced by the granulosa cells of the ovary with serum levels that grow until puberty, remain stable up to 30 years and then begin to decline until menopause. It is mainly produced by pre-and early antral follicles with an average diameter of 5-8 mm and it indirectly represents the ovarian reserve (OR). The purpose of this review is to identify what can currently be done with AMH, according to the most recent scientific evidence. AMH does not appear to be a marker for fertility as it does reflect the quantity but not the quality of follicles. It is not able to predict the spontaneous onset of pregnancy, nor the pregnancy rate in cycles of assisted reproduction technology (ART) but is a good predictor of ovarian response to hyperstimulation and it is useful in planning a couple's fertility treatment even in the case of women undergoing chemotherapy, radiotherapy and ovarian surgery. It helps to identify women suffering from mild forms of polycystic ovary syndrome (PCOS) and diagnose and manage menopause and premature ovarian failure (POF). Finally, AMH levels may be used in case of granulosa cells tumors, both for diagnosis and follow up after surgery.