Comparison of Preoperative and Postoperative Anti-Mullerian Hormone Levels in Patients Operated for Ovarian Torsion

AMH Changes After Ovarian Torsion Surgery

Abstract

Objective: This study aimed to investigate how surgical treatment affects ovarian reserve in patients with ovarian torsion who desire fertility, by comparing preoperative and postoperative serum anti-Mullerian hormone (AMH) levels. Additionally, it explored clinical and procedural factors potentially influencing AMH fluctuations, including the surgical method, side of torsion, and type of operation.
Methods: A total of 23 patients who underwent surgical management for ovarian torsion between 2020 and 2022 and had both pre-and postoperative AMH levels recorded were included. All hormone measurements were conducted using the same Beckman Coulter assay at a single institutional laboratory. Postoperative AMH assessments were performed at least three months following the intervention. Subgroup analyses were conducted based on operative features, including detorsion with or without cystectomy, oophorectomy status, surgical technique (laparotomy vs. laparoscopy), and laterality of torsion (right vs. left ovary).
Results: Although an overall upward trend in AMH levels was noted postoperatively, this increase did not reach statistical significance across the entire sample. A significant postoperative rise in AMH was observed among patients who did not undergo oophorectomy (p=0.014). When analyzed by surgical technique, a statistically significant increase was found in the laparotomy group (p=0.021), while no significant change occurred in the laparoscopy group. Additionally, patients with left-sided torsion showed a significant improvement in AMH levels after surgery (p=0.039).
Conclusion: Detorsion may serve as a viable surgical strategy for preserving ovarian reserve in women concerned about future fertility. The choice of surgical approach and the side of torsion appear to play a role in hormonal recovery and should be considered during preoperative planning.