Surgical excision of endometriomas and ovarian reserve A systematic review on serum antimullerian hormone level modifications

Eleven studies have been published on serum AMH levels after surgical excision of ovarian endometriomas. Most of them documented a significant decrease after surgery, thus supporting surgery-related damage to ovarian reserve.


Edgardo Somigliana, M.D., Ph.D., Nicola Berlanda, M.D., Laura Benaglia, M.D., Paola Vigano, D.Sc., Ph.D., Paolo Vercellini, M.D., Luigi Fedele, M.D.

Volume 98, Issue 6, Pages 1531-1538, December 2012



To evaluate serum AMH levels modification following surgical excision of ovarian endometriomas.


Systematic review. MEDLINE search from January 1990 to April 2012 using the combinations of medical subject heading terms endometriosis, endometrioma, endometriotic cyst and AMH or anti-mullerian hormone or MIF or mullerian inhibiting factor. Reference lists of selected studies was checked for additional potential contributions.


Published studies evaluating serum AMH level before and after endometrioma stripping.


Women with ovarian endometriomas requiring surgery


Serum AMH level assessment.

Main outcome measures:

Serum AMH level modifications.


Eleven papers satisfied our selection criteria. Data pooling was deemed inopportune owing to the heterogeneity of the study designs and of the reported parameters. Nine out of eleven studies documented a statistically significant reduction of serum AMH level following surgery. The two studies failing to document this decrease were published by the same study group and partly overlapped. The magnitude of the decline was more evident in women operated on for bilateral endometriomas.


Evidence deriving from the evaluation of serum AMH level modifications following surgical excision of endometriomas supports a surgery-related damage to ovarian reserve.

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