Impact of ovarian diseases on fertility reserve as assessed through serum AMH levels in reproductive age women

Abstract

Aims and objectivesThe aim of this study was to assess the effect of ovarian diseases on fertility reserve evaluating serum Anti-Mullerian Hormone (AMH) levels. Materials and methodsThis was a prospective study conducted on 66 reproductive age patients operated for an ovarian mass in the Department of Obstetrics and Gynaecology of a tertiary care teaching hospital in North India. The study included n = 18 cases of ovarian cancer, n = 20 cases of endometrioma and n = 28 cases of other benign ovarian disease. 5 ml of venous blood sample was obtained prior to surgical intervention for serum AMH analysis. Fertility sparing surgeries were done in n = 48 cases and n = 18 cases underwent radical surgeries. Histopathology (HPE) reports were recorded for all cases post-surgery. Serum AMH was correlated with HPE report to see the effect of various ovarian diseases on fertility status. ResultSerum AMH levels in malignant (0.34 ± 0.44 ng/mL) and endometrioma cases (1.50 ± 0.62 ng/mL) were significantly lower (p < 0.05) as compared to those found in cases affected by other inflammatory/benign cyst (3.93 ± 4.76 ng/mL). Ovarian cancer cases had the lowest serum AMH value (0.34 ± 0.44 ng/mL), well below the normal range. ConclusionOvarian cancer has an important adverse effect on ovarian fertility reserve, greater than endometriomas. Other benign ovarian tumors do not affect fertility reserve.