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. 2018 Jan-Dec:14:1745506518778992.
doi: 10.1177/1745506518778992.

Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation

Melanie Henes  1 , Tobias Engler  1 , Florin-Andrei Taran  1 , Sara Brucker  1 , Katharina Rall  1 , Birthe Janz  2 , Barbara Lawrenz  1
Affiliations

Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation

Melanie Henes et al. Womens Health (Lond). 2018 Jan-Dec.

Abstract

Previous publications suggest a reduction in the ovarian reserve following ovarian surgery. The influence of the underlying disease, histology, size of the ovarian cyst and type of procedure remains unclear. The aim of this study was to investigate the influence of an ovarian operation on the ovarian reserve, based on the anti-Müllerian hormone levels. The anti-Müllerian hormone values were determined by means of a standardized enzyme-linked immunosorbent assay. In total, 52 patients with one or more ovarian cysts of different histologic entities treated at the Department of Women's Health at the Women's University Hospital in Tübingen were included in the study. Anti-Müllerian hormone was determined before and after surgery. The patients were 28 (range = 18-40) years old on average. There was a statistically significant decrease in anti-Müllerian hormone from 3.94 ± 3.18 to 3.14 ± 2.57 ng/mL (p = 0.001). In 80.8%, the cysts were unilateral, and in over 90.4%, a complete cyst extirpation was performed. A statistically significant reduction was seen in follicular cysts (4.72 ± 3.84 to 3.76 ± 2.91 ng/mL; p = 0.039) and endometriosis cysts (2.55 ± 1.87 to 1.72 ± 1.39 ng/mL; p = 0.024). Also, the size of the cysts had an influence on the ovarian reserve, only larger ovarian cysts with a diameter of 5 cm or more showed a statistically significant reduction in anti-Müllerian hormone. Our data showed a significant decrease in anti-Müllerian hormone levels after surgery on the ovaries. If this results in a long-term reduced ovarian reserve or is merely a short-term reaction to the procedure needs to be clarified. However, concerning young women, the indication of surgery should be given cautiously as-at least temporarily-a reduction in the ovarian reserve can occur.

Keywords: Anti-Müllerian hormone; infertility; ovarian cyst; ovarian reserve; reproductive medicine; reproductive sciences.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Box plot showing mean AMH levels before (gray) and after (white) surgery. Box plot explanation: upper horizontal line of box: 75th percentile; lower horizontal line of box: 25th percentile; horizontal bar within box: mean; upper horizontal bar outside box: 90th percentile and lower horizontal bar outside box: 10th percentile. Circles represent outliers.
Figure 2.
Figure 2.
Box plot showing mean AMH levels before (gray) and after (white) surgery for unilateral and bilateral cystectomy.
Figure 3.
Figure 3.
Box plot showing mean AMH levels before (gray) and after (white) surgery differentiated by histologic groups.
See this image and copyright information in PMC

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