Impact of Endometriosis on Fertility Hormones and Ovarian Reserve Markers (AMH, FSH, LH)

Abstract

Background: Endometriosis is a chronic gynecological condition commonly affecting women of reproductive age and is frequently associated with infertility. Beyond mechanical and inflammatory factors, endocrine alterations may contribute to impaired fertility by affecting ovarian reserve. Hormonal markers such as anti-Müllerian hormone, follicle-stimulating hormone, and luteinizing hormone are widely used to assess ovarian reserve and reproductive potential, yet their patterns in women with endometriosis remain variably reported, particularly in routine clinical settings. Objective: To compare ovarian reserve markers, specifically anti-Müllerian hormone, follicle-stimulating hormone, and luteinizing hormone, between women with endometriosis and healthy controls. Methods: This descriptive comparative study was conducted in Islamabad over three months and included women aged 20–40 years attending gynecology clinics. Participants were divided into two equal groups: women with clinically confirmed endometriosis and age-matched healthy controls. Demographic and clinical data were recorded, and venous blood samples were obtained during the early follicular phase of the menstrual cycle. Serum anti-Müllerian hormone, follicle-stimulating hormone, and luteinizing hormone levels were measured using standardized laboratory assays. Data were analyzed using appropriate parametric statistical tests, with significance set at p < 0.05. Results: Women with endometriosis demonstrated significantly lower mean anti-Müllerian hormone levels compared with healthy controls, indicating reduced ovarian reserve. Follicle-stimulating hormone levels were significantly higher in the endometriosis group, while luteinizing hormone levels showed a modest but statistically significant increase. Baseline demographic characteristics were comparable between groups. Conclusion: Endometriosis was associated with altered ovarian reserve markers, particularly reduced anti-Müllerian hormone and elevated follicle-stimulating hormone levels. These findings emphasized the value of early hormonal assessment in women with endometriosis to support informed fertility counseling and reproductive planning.