Anti muellerian hormone serum levels in women with endometriosis: A case-control study

Objective. To compare the anti muellerian hormone (AMH) serum levels in women with and without endometriosis. Design. A case-control study Setting. Women's General Hospital, Linz, Austria. Patient(s). Our study included a total of 909 patients undergoing in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) treatment or consulting our specific endometriosis unit. After proofing the exclusion criteria, 153 of these patients with endometriosis (study group) were matched with 306 patients undergoing IVF/ICSI treatment because of a male factor (control group). Interventions. None. Main outcome measures. AMH serum level. Results. Mean AMH serum level was significantly lower in the study than in the control group (2.75 +/- 2.0 ng/ml vs. 3.46 +/- 2.30 ng/ml, p < 0.001). In women with mild endometriosis (rAFS I-II), the mean AMH level was almost equal to the control group (3.28 +/- 1.93 ng/ml vs. 3.44 +/- 2.06 ng/ml; p = 0.61). A significant difference in mean AMH serum level was found between women with severe endometriosis (rAFS III-IV) and the control group (2.38 +/- 1.83 ng/ml vs. 3.58 +/- 2.46 ng/ml; p < 0.0001). Conclusion. Lower AMH serum levels and an association with the severity were found in women with endometriosis. Physicians have to be aware of this fact. Because of the expected lower response on a controlled ovarian hyperstimulation (COH), AMH serum level should be measured to optimise the dose of gonadotropin treatment previous to a COH, especially in women with severe endometriosis.