非卵巢子宫内膜异位症切除手术前后AMH水平

IF 3.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2025-10-22 DOI:10.1016/j.jmig.2025.09.017

O Onwumere , M Holden , A Kosturakis , M Pisarska , KM Hamilton , R Meyer

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引用次数: 0

摘要

研究目的探讨非卵巢子宫内膜异位症切除术对术后抗勒氏激素（AMH）水平的影响。设计：回顾性队列研究。学术医疗中心。在2013年12月至2024年5月期间接受微创手术并在术前和术后采集AMH水平的患者或参与者。干预：非卵巢子宫内膜异位症、子宫内膜瘤切除术、宫腔镜、子宫肌瘤切除术或输卵管切除术的手术。测量和主要结果将患者分为三组：病理证实的子宫内膜异位症切除组（n = 21）、病理证实的卵巢子宫内膜异位症切除组（n = 12）和对照组（n = 40，病理或切除均无子宫内膜异位症）。病理报告用于确认子宫内膜异位症是否存在。手术前后通过EMR检测AMH水平。多变量线性回归分析用于调整从手术到amh后水平的时间。子宫内膜异位症患者AMH水平下降（中位数-0.52 ng/mL[-1.46, -0.07]）与对照组（中位数-0.26 ng/mL [-1.01, 0.02]; p = .626）比较，差异无统计学意义。子宫内膜瘤切除组与对照组相比，下降幅度更大（中位数为-0.86 ng/mL [-2.32, -0.57]）（p = .006）。子宫内膜异位症切除组与对照组有相似的变化（中位数为-0.37 ng/mL [-0.57, -0.03]）（p = .340）。子宫内膜异位症切除术与子宫内膜异位症切除术相比，后者的AMH水平下降明显更大（p = .022）。结论子宫内膜异位症切除术与对照组相比，AMH水平下降无差异，提示非卵巢子宫内膜异位症切除术不影响卵巢储备。相比之下，子宫内膜异位症切除术与子宫内膜异位症切除术和对照组相比，子宫内膜异位症切除术与卵巢储备的显著下降相关，这表明子宫内膜异位症切除术对卵巢储备有影响。

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AMH Levels before and after Non-Ovarian Endometriosis Excisional Procedures

Study Objective

To study the effects of non-ovarian endometriosis excision on levels of Anti-Müllerian Hormone (AMH) after surgery.

Design

A retrospective cohort study.

Setting

Academic medical center.

Patients or Participants

Patients who underwent minimally invasive surgery between 12/2013 - 5/2024 and had an AMH level collected before and after surgery.

Interventions

Excisional procedure of non-ovarian endometriosis, endometrioma excision, hysteroscopy, myomectomy, or salpingectomy.

Measurements and Primary Results

Patients were divided into three groups: endometriosis excision only with confirmed pathology (n = 21), ovarian endometrioma excision with confirmed pathology (n = 12), and control (n = 40; no endometriosis on pathology or excisional procedures). The pathology report was used to confirm if endometriosis was present. AMH levels were obtained from the EMR before and after surgical intervention. Multivariable linear regression analysis was used to adjust for time from surgery to post-AMH levels.

No statistically significant difference was observed in AMH level decline when comparing all endometriosis patients (median -0.52 ng/mL [-1.46, -0.07]) to controls (median -0.26 ng/mL [-1.01, 0.02]; p = .626). The endometrioma excision group showed a greater decline (median -0.86 ng/mL [-2.32, -0.57]) compared to controls (p = .006). The endometriosis excision only group had a similar change (median -0.37 ng/mL [-0.57, -0.03]) to controls (p = .340). Comparing endometriosis excision to endometrioma excision, the latter showed a significantly greater decline in AMH levels (p = .022).

Conclusion

There was no difference in the decline of AMH levels when comparing endometriosis excision to controls, suggesting that non-ovarian endometriosis excision does not affect ovarian reserve. In contrast, endometrioma excision was associated with a significant decline compared to endometriosis excision only and to control, suggesting an impact on ovarian reserve.

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.