Can the ovary be preserved? Trajectory of anti-müllerian hormone after ovarian detorsion: A retrospective cohort study

Background: This study aimed to evaluate the longitudinal trajectory of ovarian reserve by measuring serum anti-Müllerian hormone (AMH) levels in adult patients who underwent surgical detorsion for ovarian torsion, and to investigate the impact of symptom duration and selected clinical factors on postoperative AMH recovery. Methods: This retrospective cohort study included patients who underwent surgical detorsion for ovarian torsion and had serum AMH measurements available preoperatively and at 3 and 6 months postoperatively. Patients whounderwentoophorectomy orhadincompletefollow-up datawereexcluded. Demographiccharacteristics,symptomduration, torsion laterality, surgical approach, presence of polycystic ovary syndrome (PCOS), and surgical procedure (detorsion alone or detorsion with cystectomy) were recorded. Changes in AMH over time were analyzed using the Friedman test with pairwise Wilcoxon signed-rank comparisons. Subgroup differences were performed using the Mann-Whitney U or Fisher’s exact test. Results: A total of 34 patients were included in this study. Median AMH levels rose from 3.00 ng/mL (interquartile range [IQR]: 2.10–5.00) preoperatively to 4.00 ng/mL(IQR:2.60–4.88) at 3 monthsand5.00ng/mL(IQR:3.60–6.00)at6monthspostoperatively (overall p < 0.001). AMHlevels were significantly higher at both 3 and 6 months compared with preoperative values (p = 0.021 and p < 0.001, respectively), with a further increase observed between 3 and 6 months (p < 0.001). No significant differences in AMH recovery were observed based on PCOS status, surgical approach, surgical procedure, or torsion laterality. Conclusions: Ovarian reserve recovery after detorsion appears to be time-dependent, and longitudinal assessment of AMH provides a more informative evaluation than single postoperative measurements. Prolonged symptom duration is associated with reduced biochemical recovery of ovarian reserve, highlighting the importance of early diagnosis and prompt surgical intervention in ovarian torsion.