Abstract
Objective
To compare serum anti-Mullerian hormone (AMH) levels following hysterectomy and myomectomy.
Study design
Prospective longitudinal observational study. Serum AMH, follicle stimulating hormone
(FSH) and luteinizing hormone (LH) levels were measured pre-operatively (T1) and 2
days (T2) and 3 months (T3) following hysterectomy and myomectomy in 70 women aged
36–45 years. Hysterectomy (laparoscopy-assisted vaginal hysterectomy = 10; total abdominal hysterectomy = 25) with conservation of both ovaries for benign diseases of the uterus was performed
in 35 women, and myomectomy (laparoscopy myomectomy = 15; open myomectomy = 20) was performed in another 35 women. The follow-up period was 3 months following
surgery. The results were analysed using the t-test or one-way analysis of variance by repeated-measures ANOVA.
Results
Serum AMH in the hysterectomy group was 1.08 ± 0.77 ng/ml at T1, 0.78 ± 0.58 ng/ml at T2 and 0.81 ± 0.58 ng/ml at T3; the level was significantly lower at T2 and T3 compared with T1. In the
myomectomy group, the corresponding values were 1.54 ± 0.95 ng/ml, 1.18 ± 0.77 ng/ml and 1.50 ± 0.58 ng/ml; serum AMH was significantly lower at T2 compared with T1, but the difference
between T3 and T1 was not significant. There were no significant differences in serum
FSH and LH in either group between these three time points.
Conclusion
Serum AMH was significantly lower 2 days and 3 months following hysterectomy compared
with the pre-operative level. Following myomectomy, serum AMH was significantly lower
than the pre-operative level 2 days following the procedure, but was similar to the
pre-operative level 3 months after surgery. Therefore, hysterectomy may have a more
lasting adverse effect on ovarian reserve than myomectomy. A long-term study of AMH
levels is needed.
Keywords
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Article info
Publication history
Published online: October 16, 2013
Accepted:
September 27,
2013
Received in revised form:
July 16,
2013
Received:
March 1,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
