Serum anti-Müllerian hormone recovery after ovarian cystectomy for endometriosis: A retrospective study among Korean women

Serum anti-Müllerian hormone (sAMH) is a useful marker of ovarian reserve. In many patients, the sAMH levels gradually recover after falling to the lowest level after surgery (nadir phenomenon). This study aimed to analyze the factors related to sAMH recovery from the nadir after an ovarian cystectomy for endometriosis among Korean women. A total of 159 patients with ovarian endometriosis were included in the study. The sAMH levels were measured before surgery and at least twice within 12 months after the surgery. The patients were divided into two groups: those with recovery (nadir group) and those without recovery (reduction group). Postoperative recovery of the sAMH levels from the nadir was not related to the stage and bilaterality of the lesion, surgical methods, such as robot-assisted or laparoscopic surgery, or surgical time. In the nadir group, the level of preoperative cancer antigen 125 was significantly higher, and it decreased significantly after the surgery than in the reduction group (P = .02 and P = .02). Additionally, the postoperative C-reactive protein (CRP) level was significantly higher in the nadir group, and it increased significantly after the surgery than in the reduction group (P = .03 and P = .04). The increasing degree of perioperative CRP level showed a cutoff value on the receiver operating characteristic curve (0.735 mg/dL, area under curve = 0.604; P = .04). Increased serum CRP levels after surgery are significantly related to the recovery of sAMH levels from the nadir. Therefore, postoperative serum CRP level could be used as a marker to predict the sAMH nadir after surgery.