陆军军医大学学报 (Nov 2023)
Effect of laparoscopic surgical procedures on serum anti-Mullerian hormone level
Abstract
Objective To investigate the effect of 3 laparoscopic surgical procedures (hysterectomy, oophorectomy and fallectomy) on anti-Mullerian hormone (AMH) level. Methods A total of 162 women who were treated with laparoscopic surgical procedures (56 cases of hysterectomy, 52 cases of oophorectomy and 54 cases of fallectomy) in our department from November 2019 to February 2021 were enrolled in this study. The AMH level of each patient was compared preoperatively, and 1, 3 and 6 months postoperatively. The changes in AMH for the same type, different surgical procedures, were also compared. Results No statistical difference was observed in preoperative serum AMH level among the 3 groups of patients (P>0.05), and the level was significantly decreased in the ovarian and hysterectomy groups than the fallopian tube group in 1 month postoperatively (P=0.04). At 3 and 6 months postoperatively, there was no difference in serum AMH level in the 3 groups (P=0.1, P=0.33), and △AMH level was decreased gradually. For the same type, different surgical procedures, when compared with subtotal hysterectomy, serum AMH level was decreased more significantly in patients with total hysterectomy at 1, 3 and 6 months postoperatively than preoperative level (P=0.016, P=0.021, P=0.021), and the decrease in AMH was more obviously in bilateral than in unilateral oophorectomy. Conclusion All these 3 types of common laparoscopic gynecological surgeries affect ovarian function, with ovarian surgery most significant, followed by hysterectomy and then salpingo-oophorectomy. Total uterine resection has more obvious effect on postoperative decline in ovarian reserve than sub-total uterine resection, and bilateral salpingo-oophorectomy than unilateral salpingo-oophorectomy, especially in 1 month postoperatively, while no such effect is observed in unilateral salpingo-oophorectomy.
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