To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone (AMH). A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy (TLH group, n=32), laparoscopic subtotal hysterectomy (LSH group, n=31) and laparoscopic myomectomy (LM group, n=33). Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation. No significant differences existed in AMH in LM group[(1.42±0.65), (1.31±0.53) & (1.33±0.61) μg/L, P>0.05]. The levels of AMH in both groups were significantly lower than those at pre-operation[(1.17±0.11), (1.01±0.10), (0.48±0.54) & (1.18±0.93), (0.45±0.39), (0.14±0.0) μg/L, P<0.001]. The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up[(-37.4±37.6)% vs. (-27.0±23.0)%, P=0.017]. The results showed that LM had no effect on ovarian reserve. Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

Hysterectomy, laparoscopic; Ovarian function