क्या Endometriosis से AMH कम होता है ? 

UPDATED ON 21 MAY. 2025

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Endometriosis

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Endometriosis is a painful condition in which tissue that looks like the lining of your uterus grows outside of it. The ovaries, fallopian tubes, and pelvic tissue are all affected by endometriosis. The granulosa cells produce anti-Mullerian hormone, or AMH, in your ovarian follicles.

The production of AMH reflects your ovarian reserve (egg count). You’re born with a basket full of eggs, which gets used up over your lifetime. An AMH test tells you your egg count. This article will focus on the effect of endometriosis on AMH value.

Where does endometriosis take place?

Endometriosis can be found in a variety of places.

• Endometriosis most commonly affects the ovaries, where it forms what’s known as a chocolate cyst. These cysts block the normal flow of menstrual blood, causing it to collect and turn from red to a dark brown color—hence the name “chocolate cyst.”

• Secondly, endometrial expansion occurs behind the uterus (rectum tube).

• Third, endometrial enlargement in the vaginal canal creates great discomfort during sexual activity, and the fallopian tubes are the fourth organ.

• Endometriosis has two major consequences: pain and infertility.

What is an AMH blood test?

Anti-mullerian hormone, or AMH, is a laboratory test used by gynecologists and fertility specialists to determine a woman’s ovarian reserve, or egg count.

The tiny follicles in a woman’s ovaries create this hormone. The AMH value is considered low if the count is less than 1.5. The normal range is 1-4 for the AMH value.

What is Laparoscopic surgery?

If the size of a chocolate cyst is more than 4 cm, doctors suggest laparoscopy surgery.

Laparoscopy is a procedure for examining and removing implants and scar tissue from the pelvic organs. Severe endometriosis and scar tissue suspected of interfering with internal organs create a problem in conceiving. The chocolate cyst is evacuated during this procedure to save the ovaries.

A small portion of the ovaries is usually damaged during this procedure, potentially lowering AMH levels. Patients’ AMH readings are recorded before and after surgery for 4-6 months.

Usually, the type of surgery that is performed on the ovary in order to remove the entire endometriosis is dependent a lot on the surgeon who is perform Many times, we choose to perform either excision or ablation of the endometriotic cyst which is present in the ovary.

Our counseling to the patient is such that there can be a drop in the AMH value. Immediately after the surgery, the value of AMH will return to its original value or at least 90% of its original value in the next 4 to 6 months following the surgery. 

If the patient is having very low AMH, which is typically less than 1.5, then in that situation, we recommend to the patient that rather than doing any form of excisional surgery, the patient can form and also opt for alcohol ablation. 

Ethanol sclerotherapy is a very good method to treat the recurrence of endometriotic cysts, especially in patients who have a low AMH.

What is the exact technique for performing ethanol sclerotherapy?

After that, the entire endopatriotic fluid is aspirated out. Once the endometriotic fluid is aspirated out completely, then approximately 20 mL of normal saline is injected. After 20 mL of normal saline is injected.

It is kept inside for approximately 3 to 5 minutes. It is then aspirated out completely. Then, a pre-calculated dose of medical-grade, 100 percent ethyl alcohol is injected inside the cyst, and it is maintained inside for approximately 20 minutes.

In some cases, we try to maintain it inside for approximately 30 minutes. This is the exposure time that the inner surface of the cyst requires in order to maintain a complete chemical ablation. 

After that, yet another wash is given inside the endometriotic cyst, and the cyst is completely compressed out. This procedure takes approximately 30 to 40 minutes. It is considered to be a daycare procedure. It is expensive because it requires a great amount of expertise.

 However, it is to be only offered to women who are experiencing a low AMH or who are having assisted, which is less than 4 cm.

Some things to keep in mind

It is essential to remove the entire ovary if cysts are present in both ovaries. Doctors also propose removing the ovaries if they have been destroyed inside due to endometriosis.

Make sure you go to a reputable and skilled gynecologist because this procedure is vital. If this operation is vital for you, don’t wait too long to execute it.

If a patient has deep endometriosis, it is necessary to remove the endometriosis. The couple is encouraged to undertake IVF therapy if the lady has Grade 4 endometriosis, the most advanced form of endometriosis. There is a compelling argument that IVF is the only way to conceive.

The majority of people assume that a natural pregnancy is all they seek. Even if they have grade 4 (deep endometriosis), they want to get pregnant naturally. They must carefully study their situation with a doctor to get a realistic assessment.

Patients with grade 2 or 3 endometriosis can continue to pursue natural methods of conception or IUI treatment after the endometriosis surgery has been successful. After this surgery, the changes are positively visible.

Conclusion

Please look at your AMF values. AMH is a test that assesses ovarian reserve and can help women feel better about their ovarian reserve, especially if they wish to put off raising a family.

It can also assess fertility in women with a little ovarian reserve who should not wait to conceive a family.

When used in conjunction with other diagnostic criteria, the AMH test can assist in determining how a woman will react to stimulation medicines. Predicting the ovarian response before treatment allows clinicians to make an educated decision regarding the treatment protocol, which impacts the cycle’s success.

For more information on endometriosis and AMH, reach out to our expert team. Shree IVF Clinic provides advanced endometriosis treatment in Mumbai, India.

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IVF

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Endometriosis

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