| Objective:To observe the change trend of serum AMH level in patients with ovarian benign tumors after surgery,to study the recovery of ovarian function after surgery,and to explore the relationship between ovarian benign tumors and the recovery of ovarian function after surgery.It provides a theoretical basis for the research on the recovery of ovarian function after the removal of benign ovarian tumors in clinical practice.Method:1.From January2016 to April 2017,a total of 74 cases of patients with ovarian benign tumors who received laparoscopic cystectomy in Zaozhuang maternal and child health hospital and central hospital of Zao mining group were selected as the research group.They were aged 20-45 years old.Another 50 healthy women without ovarian cysts were selected as the control group.Preoperative age,menstrual cycle,number of births,BMI,FSH,LH,FSH/LH,E2,AMH and AFC were compared between the control group and the study group.2.79 patients were divided into groups according to age,postoperative pathological results,lesion location and tumor size.Serum AMH levels and AFC counts were monitored preoperatively and postoperatively at 1,3,and 6 months,as well as AMH levels at 12 months after surgery.3.AMH level is tested by automatic Access AMH detection system.Result:(1)There was no significant difference in AMH,AFC,FSH,FSH/LH,age,menstrual cycle,number of births,BMI,LH,E2 between the study group and the control group before surgery(p>0.05).The serum AMH and ultrasonic AFC in the study group showed similar changes before and after the operation,which dropped to the lowest level1 month after the operation(p<0.05),then gradually recovered,and approached the preoperative level 6 months after the operation until 12 months after the operation(p<0.05).(2)Preoperative AMH level in the younger group was higher than that in the older group(4.09±2.33,3.24±2.27,2.96±1.29 ng/ml in the groups aged 20-25,26-35,and36-45,p<0.05).There was no significant difference among groups with different pathological types,unilateral and bilateral,and cyst size(p<0.05).(3)AMH in the groups aged 20-25,26-35 and 36-45 decreased to(60.2±29.38)%,(47.2±3.85)% and(38.5±37.98)% of the preoperative level at 3 months after the operation(p<0.05),and there was no statistical difference between the groups 6 and 12 months after the operation and their respective preoperative levels(p>0.05).(4)At 1,3,6 and 12 months after surgery,the AMH levels in the endometriosis cyst group decreased to(14.7±1.98)%,(28.3±35.32)%,(52.6±6.98)%,(70.7±42.23)% of the preoperative levels,while the non-endometriosis cyst decreased to(23.8±4.32)%,(48.7±36.57)%,(97.9±45.99)%,(95.0±75.56)%.Within 12 months after surgery,there was a statistical difference between the endometriosis cyst group and the preoperative one(p<0.05),while there was no difference between 6,12 months postopererative and preoperative AMH level in non-endometriosis cyst group(p>0.05).(5)At 1,3 and 6 months after surgery,the rates in the unilateral group decreased to(32.9±4.31)%,(65.2±41.2)%,(98.4±44.7)%,and the rates in the bilateral group decreased to(23.0±35.0)%,(36.7±32.7)%,(78.1±28.6)%.There was no difference between the unilateral group and the preoperative group 6 and 12 months after the operation(p>0.05),and there was no difference between the bilateral group and the preoperative group 12 months after the operation(p>0.05).Conclusion:1.AMH can be used as a reliable indicator of ovarian reserve function,and the ovarian reserve function was reduced after the removal of benign ovarian tumor,which showed a trend of recovery after reduction.2.Age,pathological type,tumor size and involved location are all important factors that can be considered as influencing the ovarian reserve function after surgery.Among them,the recovery of ovarian reserve function after surgery is significantly correlated with the pathological type,unilateral and bilateral ovarian tumor,while non-endometriosis cyst and unilateral benign ovarian tumor recover faster.3.The ovarian reserve function of benign ovarian tumors can be restored to a good level early after the operation by taking appropriate ovarian protection measures during and after the operation. |
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