Hua Yuan1, Chunyan Wang2, Dongjie Wang2, Yifeng Wang3. 1. Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China; Department of Gynecology, Maternal and Child Health Hospital of Wuxi, Wuxi, China. 2. Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. 3. Department of Gynecology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. Electronic address: wangyifengmedical@126.com.
Abstract
STUDY OBJECTIVE: To compare prospectively the impact on ovarian reserve of total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH) for treating uterine fibroids as measured by serum anti-Mullerian hormone (AMH) levels. DESIGN: In this prospective study, 83 patients (aged 38-47 years) with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43) with conservation of both ovaries. Of these, 33 patients from the TLH group and 34 patients from the LSH group completed follow-up (Canadian Task Force Classification II-2). SETTING: Hospital. PATIENTS: Eighty-three patients aged 38-47 years. INTERVENTIONS: Patients with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43). MEASUREMENTS AND MAIN RESULTS: Changes in ovarian reserve were investigated by measuring serum levels of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) before surgery and at 1 month and 4 months after surgery. In both the TLH and LSH groups, serum AMH levels were significantly decreased at 1 month and 4 months postsurgery compared with baseline levels (p < .001). The decrease in serum AMH levels was greater in the TLH group than in the LSH group at 1 month postsurgery, but the difference was not statistically significant. The decrease in serum AMH levels was significantly greater in the LSH group at 4 months postsurgery (p < .001). In both groups, no significant changes in serum FSH, LH, or E2 levels were seen at 1 month or 4 months (p > .05). CONCLUSION: Serum AMH levels were decreased significantly at 4 months after hysterectomy, with a greater decrease in the TLH group compared with the LSH group, indicating the prognostic importance of serum AMH level in reflecting ovarian reserve in patients undergoing hysterectomy.
STUDY OBJECTIVE: To compare prospectively the impact on ovarian reserve of total laparoscopic hysterectomy (TLH) and laparoscopic supracervical hysterectomy (LSH) for treating uterine fibroids as measured by serum anti-Mullerian hormone (AMH) levels. DESIGN: In this prospective study, 83 patients (aged 38-47 years) with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43) with conservation of both ovaries. Of these, 33 patients from the TLH group and 34 patients from the LSH group completed follow-up (Canadian Task Force Classification II-2). SETTING: Hospital. PATIENTS: Eighty-three patients aged 38-47 years. INTERVENTIONS:Patients with symptomatic uterine fibroids underwent either TLH (n = 40) or LSH (n = 43). MEASUREMENTS AND MAIN RESULTS: Changes in ovarian reserve were investigated by measuring serum levels of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) before surgery and at 1 month and 4 months after surgery. In both the TLH and LSH groups, serum AMH levels were significantly decreased at 1 month and 4 months postsurgery compared with baseline levels (p < .001). The decrease in serum AMH levels was greater in the TLH group than in the LSH group at 1 month postsurgery, but the difference was not statistically significant. The decrease in serum AMH levels was significantly greater in the LSH group at 4 months postsurgery (p < .001). In both groups, no significant changes in serum FSH, LH, or E2 levels were seen at 1 month or 4 months (p > .05). CONCLUSION: Serum AMH levels were decreased significantly at 4 months after hysterectomy, with a greater decrease in the TLH group compared with the LSH group, indicating the prognostic importance of serum AMH level in reflecting ovarian reserve in patients undergoing hysterectomy.