Immediate and Delayed Impact of Ovarian Cystectomy on Serum AMH Levels and Ovarian Reserve
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Abstract
Background: Ovarian cystectomy is widely performed for benign ovarian cysts in women of reproductive age. However, its impact on the ovarian reserve, particularly as reflected by serum Anti-Müllerian Hormone (AMH) levels, remains a concern. This study aimed to evaluate the immediate and delayed effects of ovarian cystectomy on AMH levels, considering the cyst type and laterality.
Methods: This observational study was conducted at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from February 2023 to January 2024. A total of 200 women who underwent ovarian cystectomy were enrolled in the study. Serum AMH levels were measured preoperatively and at 7 days, 1 month, and 3 months postoperatively. Data were analyzed using SPSS version 25.0, and a p-value of less than 0.05 was considered statistically significant.
Results: The Mean AMH level significantly declined from a preoperative level of 3.31 ± 1.3 ng/mL to 2.10 ± 1.1 ng/mL on day 7 (36.5% decrease, p < 0.001), partially recovering to 2.42 ± 1.2 ng/mL at 1 month and 2.51 ± 1.0 ng/mL at 3 months (24.2% reduction from baseline, p < 0.001). Endometriomas showed the most significant decline (32.7%), followed by dermoid (19.3%) and serous/mucinous cysts (13.5%). Bilateral cystectomy resulted in significantly higher AMH reduction than unilateral procedures (37.2% vs. 18.2%, p < 0.001).
Conclusion: Ovarian cystectomy leads to a significant but partially reversible reduction in ovarian reserve. Surgical approach and patient selection should be individualized to minimize the reproductive impact.