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.
Keywords: anti-Müllerian hormone; fertility preservation; follicle density; ovarian reserve; ovarian tissue cryopreservation.