Investigation of The Effect of Myomectomy on Anti-Mullerian Hormone Level in Women with Uterine Leiomyoma: A Prospective Quasi-Experimental Study.

Abstract

Background: Myomectomy is commonly performed on women diagnosed with symptomatic uterine leiomyoma(s). This study aimed to evaluate the effects of myomectomy on the serum anti-Müllerian hormone (AMH) levels in women with uterine myoma.

Materials and methods: In this prospective quasi-experimental study, 93 patients with uterine leiomyoma aged 18- 45 years were enrolled and underwent open and laparoscopic myomectomy. The participants' baseline characteristics were recorded. The level of AMH was measured and recorded before and six months after the surgery for each patient. The size, number, and type of myoma, the duration of surgery, the volume of bleeding during surgery, the need for blood transfusion, and postsurgical complications were investigated at 6-month intervals after the surgery. Data were analyzed by SPSS version 26.

Results: The AMH level decreased significantly after the surgery compared to before the surgery in both groups of laparotomic and laparoscopic myomectomy patients (P<0.001). The rate of AMH drop was lower in the laparoscopy group than in the laparotomy group (P<0.001). Among the studied variables, changes in AMH level showed a direct and significant correlation with myoma size and type. Postoperative pain, fever, and surgical site infection (SSI) were the most frequent postsurgical complications. In post-surgical period, fever rate was 12.3% in the laparotomy group, and 6.1% in the laparoscopy group, and pain (measured by visual analogue scale) was higher in the laparotomy group compared to the laparoscopy group (21 vs. 7.3%). SSI rate was 0.9% in the laparoscopy group compared to 6.3% in the laparotomy group. The size of the myoma had no significant effect on the occurrence of these complications.

Conclusion: Myomectomy may lead to a significant decrease in AMH levels in women with uterine leiomyoma undergoing both open and laparoscopic myomectomies, and the size and type of myoma significantly affects the changes in the hormone.