Comparison of Postoperative Ovarian Reserve Function Following Laparoscopic Hysterectomy and Laparoscopic Myomectomy: A Prospective Comparative Pilot Study

Abstract

This prospective study aimed to investigate the impact of laparoscopic hysterectomy (LH) and laparoscopic myomectomy (LM) on ovarian reserve by comparing serum anti-Mullerian hormone (AMH) changes following surgery. Serum AMH levels were measured preoperatively (AMH0), and 7 days (AMH1), 2 months (AMH2), and 6 months (AMH3) after LH and LM in 79 premenopausal women (LH = 59; LM = 20). AMH0, AMH1, AMH2, and AMH3 were significantly higher in the LM group than in the LH group (p = 0.012, 0.001, 0.001, and 0.015, respectively). Since there are differences in indications between myomectomy and hysterectomy, logically, women who underwent myomectomy were younger and had higher AMH baseline levels. In addition, AMH changes at 7 days postoperatively from the baseline level were significantly decreased in the LH group compared to those in the LM group (p = 0.042). However, AMH changes at 2 months and 6 months postoperatively, compared to the baseline level, were not different between the two groups (p = 0.053 and 0.752, respectively). Moreover, the significant decrease in AMH (more than 60% decrease from the baseline level) was not different at 7 days, 2 months, and 6 months postoperatively between the two groups (p = 0.415, 487, and 0.364, respectively). Our data suggest that serum AMH levels were significantly decreased directly after LH, which suggests that LH may have adverse effects on ovarian reserve. However, mid-term follow-up showed that the damaged ovarian reserve in women who underwent LH may be partially restored in 6 months.

Long-term efficacy of fibroid devascularization with ultrasound-guided high-intensity focused ultrasound

“…No significant change in the AMH level and three patients with the reversible endometrium injury after the intervention have been observed in this study. Cho et al and Yan et al showed that the AMH level decreased significantly in the first month after surgery [24,25]. Because the blood supply to the ovary comes partially from the uterine artery, UAE may also affect the collateral blood supply to the ovaries.…”

Effect of hysterectomy on ovarian function: a systematic review and meta-analysis

“…Initially, 11,911 potential citations were retrieved from the electronic databases, and 42 additional studies were identified by manually searching the reference lists of the included studies. Ultimately, 14 articles were included in the final analysis, including 5 studies examining AMH [20][21][22][23][24], 10 studies examining FSH [11,22,[24][25][26][27][28][29][30][31], 4 studies examining inhibin B [22,29,30,32], 5 studies examining E2 [22,[28][29][30][31] and 5 studies examining LH [24,[28][29][30][31].…”