OBJECTIVE:
To analyze the ovarian reserve via measurement of follicular density and anti-Müllerian hormone (AMH) in endometriosis patients participating to a clinical program of cortical ovarian cryopreservation.
DESIGN:
Retrospective analysis of serum AMH levels and prospective investigation of ovarian follicle number.
SETTING:
University Hospital.
PATIENTS:
Two hundred and two women with endometriosis and 400 controls.
INTERVENTIONS:
Blood samples and ovarian biopsies.
MAIN OUTCOME MEASURES:
Correlation of serum AMH levels and the number of non-growing follicles in the biopsied cortical tissues in endometriosis and control subjects, including age, type of AMH kit, and the laboratory performing the analysis as covariates.
RESULTS:
AMH levels were shown to decrease with age in untreated endometriosis patients (P < 1.0 × 10-5) but they were significantly lower in endometriosis compared to controls only in patients over 36 years old (P = 2.7 × 10-4). The AMH decrease was faster in endometriosis compared to controls (beta = 0.27, P = 4.0 × 10-4). Primordial follicle number decreased with the reduction of AMH levels in both cases and controls (beta = 0.3; P = 0.04).
CONCLUSION:
AMH is a reliable marker of ovarian reserve in endometriosis patients, and it can predict follicular density in women undergoing ovarian tissue cryopreservation.
