AMH levels reach similar levels in women with varying endometrioma sizes by six months post-cystectomy

The impact of cyst size on ovarian reserve before and after surgery remains debatable.

A recent study assessed whether cyst size influences pre- and postoperative ovarian reserve impairment in patients with endometrioma.

This systematic review and meta-analysis adopted a comprehensive search strategy encompassing PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure databases from their inception until October 13, 2023. Prospective studies were included comparing ovarian reserve parameters in patients with endometrioma preoperatively and at various postoperative intervals. Studies defined large and small cyst groups based on self-determined cut-off values. A bias assessment was performed using the Newcastle–Ottawa Scale. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were used for statistical analysis. Primary and secondary outcomes included serum anti-Müllerian hormone (AMH) and antral follicle count (AFC) levels before and after surgery.

Seven trials with 603 participants qualified for meta-analysis. Regardless of cut-off values, AMH levels were significantly lower in large cyst groups one month postoperatively. When cyst size was set at 5 cm, AMH levels remained lower, and for a 7 cm cut-off, differences persisted for three months. However, AMH levels became equivalent amongst the groups – at six months postoperatively. AFC showed no significant differences preoperatively or even after one month postoperatively.

AMH levels in patients with varying endometrioma sizes reached similar levels six months after laparoscopic cystectomy. These findings provide insights into the prognostic assessment of patients undergoing surgery for large endometriomas.

Source: Liu W, Zhao T, Zheng Z, Huang J, Tan J. International J Gynec & Obst. 2025.