Studies Of Anti-mullerrian Hormone On The Ovarian Reserve Functions With Endometriosis

Objective: Endometriosis（EMs）is one of common gynecologicaldisorders,characterized by the growth of ectopic endometrial cells andaffecting the childbearing age women mainly. Many studies were mostly aboutthe influence on the ovarian reserve function in patients with EMs by differentsurgical methods. However, there are few researches on the influence ofovarian reserve function of the patients with EMs. Now there is no unifieddiagnostic criteria for evaluating ovarian reserve function.There are manyways to predict ovarian reserve function, such as age, basic hormonesfollicle-stimulating hormone (FSH)，estradiol(E2), antral follicle count (AFC)and ovarian volume. In recent years it has been proved that antimullerianhormone(AMH)) provided an important referenced value on the assessment ofovarian reserve function.The purpose of this study was to evaluate the ovarian reserve function ofpatients with endometriosis, to explore the influence on female ovarian reservefunction by AMH,FSH,LH and E2as main indicators of detection, and toanalyse the predictive value of AMH in early predicting the decreasing ovarianreserve function.Methods: The women outpatient of service of gynaecology departmentin the first hospital of Qin Huangdao from September2012to March2013were inrolled in this study. All the patients have certain surgical indications.Group A (experimental group) contained30cases with endometriosisconfirmed by laparoscopy and pathology; group B (control group) contained30cases without endometriosis. Both height and weight of the patients in twogroups were measured, and then Body Mass Index (BMI) calculated. ELISAand chemiluminescence method were used to measure basic serumAMH,FSH,LH and E2of the patients in both groups before surgery and the patients in group A6months after surgery on menstrual2-4days. The contentof AMH of ovarian tissue of patients in two groups was detected byimmunohistochemical.Results:1The comparison of age and BMI between the patients of two groups:Thecomparison of age and BMI between the two groups have no statisticaldifference (P>0.05).2The comparison of the basic serum hormone level between the patients oftwo groups before surgery:The serum AMH of group A is less than that ofgroup B, with statistical significance (P<0.05). The comparison of the basicserum FSH,LH,E2and the rate of FSH/LH between the two groups have nostatistical significance(P>0.05).3The comparison between the preoperative and postoperative hormonelevel of group A: The postoperative serum AMH of group A is less thanpreoperative level; the rate of FSH/LH is higher than preoperative level, withstatistical significance(P<0.05). The comparison of FSH,LH and E2betweenthe preoperative and postoperative hormone level have no statisticalsignificance (P>0.05).4The correlation analysis between the age and AMH,FSH,LH,E2: SerumAMH level is negatively correlated with age, and serum FSH level ispositively correlated with age, with statistical significance(P<0.05). SerumLH,E2levels have no correlation with age(P>0.05). Serum AMH has norelationship with FSH,LH and E2(P>0.05).5There is no difference of AMH levels in the ovarian tissue of the patients oftwo groups (P>0.05).6The comparison of the value of predicting ovarian reserve function of thedetection indexs:According to the ROC curve, AMHAUC=0.818(P<0.05). Thespecific degrees and the sensitivity of predicting the reduing ovarian reservefunction of AMH is respectively0.733、0.767. Compared to FSH、LH、E2andFSH/LH, AMH was found to be the best predictor of ovarian reserve. Conclusions:1The detection of AMH is sensitive in predicting the ovarian reserve.2The ovarian reserve function of the patients with endometriosis is lower thanthat without endometriosis. AMH can serve as a future indicators on theassessment of ovarian reserve function in patients with endometriosis.3The surgery on endometriosis accelerates ovarian reserve falling. Doctorsshould take appropriate measures to reduce the damage to the patients and toextend childbearing age.