Does preoperative antimüllerian hormone level influence postoperative pregnancy rate in women undergoing surgery for severe endometriosis?

Abstract

The probability of postoperative pregnancy was comparable between women with low and normal AMH level who were managed for stage 3 and 4 endometriosis and who were a mean age of 30 years. However, the small sample size might have been unable to detect differences in pregnancy and live-birth rates between the two groups. As the majority of pregnancies were spontaneous, our results suggest that surgical management may be offered to young patients with severe endometriosis and reduced ovarian reserve with good fertility outcomes.

Clinical application of serum anti‐Müllerian hormone as an ovarian reserve marker: A review of recent studies

“…Ablation using plasma energy did not negatively impact postoperative serum AMH levels or pregnancy rates after assisted reproduction . Similarly, the pregnancy rate after ablation of plasma energy was reportedly comparable regardless of preoperative serum AMH levels …”

Swimming Against the Stream: Is Surgery Worthwhile in Women with Deep Infiltrating Endometriosis and Pregnancy Intention?

“…It is important to modify management with a long-term approach determined by the association of the above-mentioned factors that lead to the complexity of reasoning and expertise required to make an appropriate decision. For example, first-line surgical treatment has its place in the management of patients with deep infiltrating endometriosis associated with bilateral ovarian endometriomas and a reduced ovarian reserve [13]. Indeed, it is in those patients with a low ovarian reserve that the response to controlled stimulation in IVF is poor and that several stimulation cycles are needed; furthermore, unsuccessful procedures may lead to the patient abandoning reproductive assistance.…”

“…Indeed, it is in those patients with a low ovarian reserve that the response to controlled stimulation in IVF is poor and that several stimulation cycles are needed; furthermore, unsuccessful procedures may lead to the patient abandoning reproductive assistance. On the other hand, women with a low ovarian reserve retain their chances to spontaneous conception, and it is precisely these cases that surgery can allow for a spontaneous conception [13]. In cases of rectal or ureteral deep endometriosis with associated endometriomas and altered ovarian reserve, the option of surgery for deep lesions without concomitant curative treatment of the ovaries can be a solution without negative impact on future IVF but with an immediate improvement in pelvic comfort and quality of life.…”

Comparison of the Efficacy and Tolerability of Dienogest and Dienogest Plus Ethinylestradiol on Endometriosis Related-Pain

“…Moreover, the recurrence rate for endometriosis after surgical excision may be as high as 50% at 5 years because it is not possible to remove all viable endometriotic tissue. Repeat surgery for recurrent disease is associated with greater harm than the first surgery, as evaluated using antral follicle count and ovarian volume (1,11). In addition, the complexity of the surgical procedure is often beyond simple excision of the endometriotic cyst or lesion and may require more extensive dissection (12).…”