THE EFFECT OF VAGINAL RADICAL TRACHELECTOMY ON OVARIAN RESERVE: SERIAL CHANGES IN SERUM ANTI-MÜLLERIAN HORMONE LEVEL

Aim. To evaluate the effect of vaginal radical trachelectomy with laparoscopic pelvic lymphadenectomy on ovarian reserve and compare it with abdominal radical hysterectomy.

Methods. We enrolled 18 women who had vaginal radical trachelectomy with laparoscopic pelvic lymphadenectomy and 16 patients who had abdominal radical hysterectomy for this study; 186 women were also included as a control group for comparison. The Mann-Whitney U test was used for comparison of patient characteristics and comparison of serum anti-Müllerian hormone levels between three groups.

Results. Serum anti-Müllerian hormone level in patients with vaginal radical trachelectomy were significantly higher than that of patients with abdominal radical hysterectomy (p<0.05). Serum anti-Mullerian hormone levels in the abdominal radical hysterectomy group was significantly lower than that in the control group (p=0.02), with no significant difference between the vaginal radical trachelectomy and control groups. These data indicated that vaginal radical trachelectomy did not affect ovarian function as for ovarian reserve.

Conclusions. Serum anti-Müllerian hormone levels could be useful as a marker of ovarian reserve after vaginal radical trachelectomy. It is important to avoid postoperative complications causing reduction in ovarian function to accomplish fertility-sparing surgery.