The Impact of Gradually Increasing Energy Dose on AMH Levels in Ovarian Drilling.

Background: To document alterations in Anti-Müllerian hormone (AMH) levels with different energy doses by monopolar cautery in ovarian drilling (OD) in rats.

Methods: Forty Wistar rats were randomly divided into 4 groups that each contained 10 animals. Group A was the Sham group. Groups B, C and D were intervention groups to which OD was applied by monopolar cautery, with 20, 60 and 120 J/ovary, respectively. The total amount of energy was calculated using the following formula: energy (J) = power (W) × duration (s) × number of punctures.

Results: The pre- and postoperative AMH levels for Groups A, B and C were not statistically and significantly different according to the Bonferroni correction (p > 0.0125). However, the postoperative AMH levels were significantly lower than the preoperative AMH levels in Group D (1.25 ng/ml (1.07-2.05) vs. 0.40 ng/ml (0.30-0.72); p = 0.012).

Conclusions: AMH is a promising marker that can be used for the individualization of the energy dose to increase OD success, but the relationship between the energy and AMH has not been documented yet. This study demonstrates that postoperative changes in AMH levels could be observed only after a certain amount of energy was applied. Further experimental animal models are needed to conclusively address this issue.