Antimullerian Hormone Level and Endometrioma Ablation Using Plasma Energy

OBJECTIVE To investigate the impact of ovarian endometrioma vaporization using plasma energy on antimullerian hormone (AMH) level. METHOD We report a prospective, noncomparative series (NCT01596985). Twenty-two patients with unilateral ovarian endometriomas≥30 mm, with no surgical antecedent and no ongoing pregnancy, underwent vaporization of ovarian endometriomas using plasma energy during the period of November 29, 2010 to November 28, 2012. We assessed AMH levels before surgery, 3 months postoperatively, and at the end of follow-up. RESULTS The mean length of postoperative follow-up was 18.2±8 months. AMH level significantly varied through the 3 assessments performed in the study, as the mean values±SD were 3.9±2.6 ng/mL before the surgery, 2.3±1.1 ng/mL at 3 months, and 3.1±2.2 ng/mL at the end of the follow-up (P=.001). There was a significant increase from 3 months postoperatively to the end of follow-up (median change 0.7 ng/mL, P=.01). Seventy-one percent of patients had an AMH level>2 ng/mL at the end of the follow-up versus 76% before the surgery (P=1). During the postoperative follow-up, 11 patients tried to conceive, of whom 8 (73%) became pregnant. CONCLUSIONS The ablation of unilateral endometriomas is followed in a majority of cases by a significant decrease in AMH level 3 months after surgery. In subsequent months, this level progressively increases, raising questions about the real factors that impact postoperative ovarian AMH production.