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Bareghamyan H, Chopikyan A, Petrosyan M, Shahverdyan N, Harutyunyan A. Influence of ovarian cysts on ovarian reserve and fertility: A case-control study. Int J Gynaecol Obstet 2024; 165:424-430. [PMID: 38059670 DOI: 10.1002/ijgo.15284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of having an ovarian cyst and undergoing cystectomy on the expression of ovarian reserve markers among adolescent females who live in Armenia. METHODS We conducted a prospective case-control study. Cases were arranged into two groups. The postoperative group (POG) included those who underwent unilateral ovarian cystectomy, and those in the benign ovarian cyst group (BOCG) had complex ovarian cysts with a diameter of 5 cm or more. Adolescents without ovarian pathologies were included in the reference group (RFG). Levels of anti-Mullerian hormone (AMH) and follicular stimulating hormone (FSH) were measured, and an ultrasound investigation of antral follicular count (AFC) was also done. RESULTS Mean differences between baseline and 6-month follow-up levels of AMH, AFC significantly decreased in both the POG and BOCG compared to the RFG. However, the decrease was more significant in the POG: a decrease of 0.86 ng/mL for AMH and 3.11 ng/mL for AFC versus decreasing by 0.61 ng/mL for AMH and 1.68 ng/mL for AFC. Meanwhile, in the BOCG, 6-month FSH levels did not show any significant changes compared to the baseline measurement. In comparison with the reference group, there was a significant decrease in the levels of AMH and AFC among participants who had endometriomas and cystadenomas. CONCLUSION Benign ovarian cysts 5 cm or more in diameter, as well as cystectomy, statistically affect OR after 6 months. Therefore, adolescents with ovarian cyst or cystectomy need individualized support to maintain reproductive age fertility.
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Affiliation(s)
- Hasmik Bareghamyan
- Department of Obstetrics and Gynecology N1, Yerevan State Medical University, Yerevan, Armenia
- "Beglaryan" Medical Center, Yerevan, Armenia
| | - Armine Chopikyan
- Department of Public Health and Healthcare Organization, Yerevan State Medical University, Yerevan, Armenia
| | - Marine Petrosyan
- Department of Obstetrics and Gynecology N1, Yerevan State Medical University, Yerevan, Armenia
| | - Nune Shahverdyan
- Department of Obstetrics and Gynecology N1, Yerevan State Medical University, Yerevan, Armenia
- "Beglaryan" Medical Center, Yerevan, Armenia
| | - Armine Harutyunyan
- Department of Obstetrics and Gynecology N1, Yerevan State Medical University, Yerevan, Armenia
- "Beglaryan" Medical Center, Yerevan, Armenia
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Rhee S, Chun S, Ji YI. Initial Preoperative Hemoglobin Level Affects the Rate of Decline in Anti-Müllerian Hormone Levels after Laparoscopic Ovarian Cystectomy in Women with Ovarian Endometriosis. J Menopausal Med 2023; 29:127-133. [PMID: 38230596 PMCID: PMC10796201 DOI: 10.6118/jmm.23024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/27/2023] [Accepted: 10/17/2023] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVES To determine the factors affecting the decline in ovarian reserve following laparoscopic ovarian cystectomy (LOC) in women with ovarian endometriosis. METHODS This retrospective study included 22 women, aged 25-45 years, with regular menstrual cycles who underwent unilateral LOC and were diagnosed with ovarian endometriosis at a university hospital. Blood samples were collected preoperatively and on the third postoperative day to determine the serum anti-Müllerian hormone (AMH) levels for assessment of the decline in ovarian reserve during the early postoperative period. RESULTS The preoperative hemoglobin level, white blood cell count, and AMH level were associated with changes in the AMH level after unilateral LOC. Among these parameters, only the preoperative hemoglobin level was correlated with the rate of decline in postoperative AMH levels. The preoperative serum AMH level was correlated with the amount of postoperative AMH change but not with its rate of decline. CONCLUSIONS Preoperative hemoglobin levels may be associated with the rate of decline in AMH levels in the early postoperative period after unilateral LOC.
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Affiliation(s)
- Soojin Rhee
- Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sungwook Chun
- Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
| | - Yong Il Ji
- Department of Obstetrics and Gynecology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Shandley LM, Spencer JB, Kipling LM, Hussain B, Mertens AC, Howards PP. The Risk of Infertility After Surgery for Benign Ovarian Cysts. J Womens Health (Larchmt) 2023; 32:574-582. [PMID: 36971598 PMCID: PMC10171942 DOI: 10.1089/jwh.2022.0385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Background: There is a growing body of evidence that ovarian cystectomy may negatively impact ovarian reserve. However, it is unclear whether ovarian cyst surgery puts women at risk of future infertility. This study investigates whether surgery for benign ovarian cysts is associated with long-term infertility risk. Methods: Women aged 22-45 years (n = 1,537) were invited to participate in an interview about their reproductive histories, including whether they ever had infertility or ovarian cyst surgery. Each woman reporting cyst surgery was randomly matched to a comparison woman, who was assigned an artificial surgery age equal to that of her match. Matching was repeated 1,000 times. Adjusted Cox models were fit to examine time to infertility after surgery for each match. A subset of women was invited to participate in a clinic visit to assess markers of ovarian reserve (anti-Müllerian hormone [AMH], antral follicle count). Results: Approximately 6.1% of women reported cyst surgery. Infertility after surgery was more common for women reporting cyst surgery than those without surgery after adjusting for age, race, body mass index, cancer history, parity before assigned surgery age, history of infertility before surgery age, and endometriosis (median-adjusted hazard ratio 2.41, 95% simulation interval 1.03-6.78). The estimated geometric mean (95% confidence interval [CI]) AMH levels of those who reported a history of ovarian cyst surgery were 1.08 (95% CI: 0.57-2.05) times those of women who reported no history of surgery. Conclusions: Those with a history of ovarian cyst surgery were more likely to report having a history of infertility compared with age-matched women who reported no history of cyst surgery. It is possible that both ovarian surgery to remove cysts and the conditions that lead women to develop cysts requiring surgery may affect subsequent successful conception.
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Affiliation(s)
- Lisa M. Shandley
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jessica B. Spencer
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lauren M. Kipling
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Banna Hussain
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ann C. Mertens
- Department of Pediatrics, Aflac Cancer Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Penelope P. Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Park EY, Hwang KH, Kim JH, Lee SH, Park KS, Choi SJ, Cha SK. Epinephrine minimizes the use of bipolar coagulation and preserves ovarian reserve in laparoscopic ovarian cystectomy: a randomized controlled trial. Sci Rep 2020; 10:20911. [PMID: 33262411 PMCID: PMC7708492 DOI: 10.1038/s41598-020-77781-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 11/12/2020] [Indexed: 11/15/2022] Open
Abstract
We propose a novel method, the epinephrine compression method (Epi-pledget), as a hemostasis method for ovarian cystectomy. A total of 179 patients undergoing laparoscopic ovarian cystectomy with stripping were randomly allocated into three groups: the bipolar coagulation group, the Epi-pledget group, and the coagulation after Epi-pledget (Epi & Coagulation) group. Serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) by ultrasonography were measured to determine the preservation of ovarian function. To evaluate the postoperative ovarian cellular proliferative activity and tissue damage in a mouse model, we operated on the ovaries of mice with an artificial incision injury and applied two hemostatic methods: coagulation and Epi-pledget. Eight weeks after surgery, the AMH rate significantly decreased in the bipolar coagulation group compared with the Epi-pledget group. The AFC decline rate was also significantly greater in the coagulation group than the Epi-pledget group. Specifically, patients with endometrioma had a significantly greater decline of serum AMH in the coagulation group than the Epi-pledget group. In a histopathological analysis in mice, the Epi-pledget group showed ameliorated fibrotic changes and necrotic findings in the injured lesion compared with the bipolar coagulation group. The Epi-pledget method for ovarian stripping has an additional benefit of maximizing the preservation of the ovarian reserve, especially for the endometriotic ovarian cyst type.
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Affiliation(s)
- Eun Young Park
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea
| | - Kyu-Hee Hwang
- Department of Physiology, Department of Global Medical ScienceMitohormesis Research Center, Institute of Mitochondrial Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea
| | - Ji-Hee Kim
- Department of Physiology, Department of Global Medical ScienceMitohormesis Research Center, Institute of Mitochondrial Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea
| | - San-Hui Lee
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea
| | - Kyu-Sang Park
- Department of Physiology, Department of Global Medical ScienceMitohormesis Research Center, Institute of Mitochondrial Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea
| | - Seong Jin Choi
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea.
| | - Seung-Kuy Cha
- Department of Physiology, Department of Global Medical ScienceMitohormesis Research Center, Institute of Mitochondrial Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwondo, 26426, Republic of Korea.
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Nankali A, Kazeminia M, Jamshidi PK, Shohaimi S, Salari N, Mohammadi M, Hosseinian-Far A. The effect of unilateral and bilateral laparoscopic surgery for endometriosis on Anti-Mullerian Hormone (AMH) level after 3 and 6 months: a systematic review and meta-analysis. Health Qual Life Outcomes 2020; 18:314. [PMID: 32972380 PMCID: PMC7513290 DOI: 10.1186/s12955-020-01561-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Endometriosis is one of the most common causes of infertility. The causes of the disease and its definitive treatments are still unclear. Moreover, Anti-Mullerian Hormone (AMH) is a glycoprotein dimer that is a member of the transient growth factors family. This research work aimed to identify the effect of unilateral and bilateral laparoscopic surgery for endometriosis on AMH levels after 3 months, and 6 months, using meta-analysis. Methods In this study, the articles published in national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were searched to find electronically published studies between 2010 and 2019. The heterogeneous index between studies was determined using the I2 index. Results In this meta-analysis and systematic review, 19 articles were eligible for inclusion in the study. The standardized mean difference was obtained in examining of unilateral laparoscopic surgery for endometriosis (before intervention 2.8 ± 0.11, and after 3 months 2.05 ± 0.13; and before intervention 3.1 ± 0.46 and after 6 months 2.08 ± 0.31), and in examining bilateral laparoscopic surgery for endometriosis examination (before intervention 2.0 ± 08.08, and after 3 months 1.1 ± 0.1; and before intervention 2.9 ± 0.23 and after 6 months 1.4 ± 0.19). Conclusion The results of this study demonstrate that unilateral and bilateral laparoscopic surgery for endometriosis is effective on AMH levels, and the level decreases in both comparisons.
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Affiliation(s)
- Anisodowleh Nankali
- School of Medicine, Department of Obstetrics and Gynecology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Kazeminia
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parnian Kord Jamshidi
- School of Medicine, Department of Obstetrics and Gynecology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Amin Hosseinian-Far
- Department of Business Systems & Operations, University of Northampton, Northampton, UK
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Chun S, Ji YI. Effect of Hysterectomy on Ovarian Reserve in the Early Postoperative Period Based on the Type of Surgery. J Menopausal Med 2020; 26:159-164. [PMID: 33423404 PMCID: PMC7797220 DOI: 10.6118/jmm.20010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/06/2020] [Accepted: 08/14/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives This study aimed to evaluate the influence of simple hysterectomy on the ovarian reserve based on the type of surgery. Methods Eighty-six premenopausal women between 31 and 48 years who underwent hysterectomy for benign gynecologic disease without additional adnexal surgery at a university hospital participated in this study. Seventy-one patients underwent laparoscopy-assisted vaginal hysterectomy (LAVH), and 15 patients underwent abdominal hysterectomy (AH). Blood samples were obtained from all study participants on preoperative day and 3 days after the operation to determine the anti-Müllerian hormone (AMH) levels. Results The postoperative reduction of the mean serum AMH level in the LAVH group (0.42 ± 0.76 ng/mL) was greater than that in the AH group, although the difference was not statistically significant (0.01 ± 0.60 ng/mL) (P = 0.053). The mean baseline AMH level (2.59 ± 2.33 ng/mL) was significantly reduced to 2.24 ± 2.08 ng/mL at 3 days after hysterectomy, and the mean rate of decline of AMH levels after surgery was 13.61% ± 30.81%. In subgroup analysis based on the type of surgery, the mean serum AMH level decreased significantly after surgery in the LAVH group, but no significant changes were found in serum AMH levels before and after the surgery in the AH group. Conclusions These preliminary results suggest that simple hysterectomy affects the early postoperative decline of ovarian reserve, and these results might vary depending on the type of surgery.
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Affiliation(s)
- Sungwook Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong Il Ji
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
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Chun S. Inter-ovarian differences in ultrasound markers of ovarian size in women with polycystic ovary syndrome. Clin Exp Reprod Med 2019; 46:197-201. [PMID: 31739656 PMCID: PMC6919203 DOI: 10.5653/cerm.2019.00374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/30/2019] [Indexed: 11/28/2022] Open
Abstract
Objective The aim of this study was to establish whether differences in ovarian size exist between the right and the left ovary of the same individual in women with polycystic ovary syndrome. Methods In total, 206 Korean women with polycystic ovary syndrome were included in this study. In all participants, a transvaginal or transrectal ultrasound examination was conducted in the early follicular phase of the menstrual cycle. Results A significant linear correlation was found between the two ovaries with regard to antral follicle count and ovarian volume. The mean antral follicle count in the right ovary (26.75±11.72) was significantly higher than that in the left ovary (23.98±10.85), and the mean volume of the right ovary (11.06±5.17 cm3) was significantly different from that of the left ovary (9.12±4.89 cm3). Conclusion Ovarian size is different between the right and the left ovary in women with polycystic ovary syndrome.
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Affiliation(s)
- Sungwook Chun
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
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Muzii L, Di Tucci C, Di Feliciantonio M, Galati G, Di Donato V, Musella A, Palaia I, Panici PB. Antimüllerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis. Fertil Steril 2019; 110:932-940.e1. [PMID: 30316440 DOI: 10.1016/j.fertnstert.2018.06.025] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/22/2018] [Accepted: 06/17/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate if the presence of endometriomas impacts on the ovarian reserve as evaluated with antimüllerian hormone (AMH). DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENT(S) Patients with unoperated endometriomas versus controls without endometriomas. INTERVENTION(S) Electronic databases searched up to June 2017 to identify articles evaluating AMH levels in patients with unoperated endometriomas versus controls without endometriomas. MAIN OUTCOME MEASURE(S) The primary analysis was aimed at evaluation of AMH levels (mean and SD) in patients with and without endometriomas. Secondary analyses were aimed at evaluating AMH levels in patients with ovarian endometriomas compared to patients with either non-endometriosis benign ovarian cysts or healthy ovaries. RESULT(S) Of the 39 studies evaluated in detail, 17 were included, for a total of 968 patients with endometriomas and 1874 without endometriomas. AMH was significantly lower in patients with unoperated endometriomas compared to patients with no endometriomas (mean difference -0.84, with 95% confidence interval [CI] -1.16 to -0.52). At secondary analyses, AMH in patients with endometriomas was significantly lower both versus non-endometriosis benign ovarian cysts (mean difference -0.85, 95% CI -1.37 to -0.32, and versus women with healthy ovaries (mean difference -0.61, 95% CI -0.99 to -0.24). CONCLUSION(S) Ovarian reserve evaluated with AMH is reduced in patients with ovarian endometriomas compared both to patients with other benign ovarian cysts, and to patients with healthy ovaries.
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Affiliation(s)
- Ludovico Muzii
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy.
| | - Chiara Di Tucci
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | | | - Giulia Galati
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Violante Di Donato
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Angela Musella
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
| | - Innocenza Palaia
- Department of Obstetrics and Gynecology, "Sapienza" University of Rome, Rome, Italy
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Muzii L, Di Tucci C, Di Feliciantonio M, Galati G, Pecorella I, Radicioni A, Anzuini A, Piccioni MG, Patacchiola F, Benedetti Panici P. Ovarian Reserve Reduction With Surgery Is Not Correlated With the Amount of Ovarian Tissue Inadvertently Excised at Laparoscopic Surgery for Endometriomas. Reprod Sci 2019; 26:1493-1498. [DOI: 10.1177/1933719119828055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to evaluate the effect of laparoscopic cystectomy on ovarian reserve by means of anti-Müllerian hormone (AMH) serial measurements and to compare AMH values with the number of inadvertently removed follicles in histological specimens. Fifty-two women were enrolled: 34 patients with endometriomas (group 1) and 18 patients with other benign ovarian cysts (group 2). All patients underwent laparoscopic cystectomy performed by a single experienced surgeon. The AMH was measured before, and 1, 3, and 6 months after cystectomy in group 1, and before and 6 months after surgery in group 2. Preoperative AMH levels (mean [standard deviation, SD]) in group 1 (3.39 [2.43] ng/mL) were not significantly different from group 2 (3.74 [2.57] ng/mL; P = .68). In group 1, a significant decrease in AMH levels of 43.4% was observed at 1 month (1.93 [1.36]; P = .003), and of 63.1% at 3 months (1.25 [1.00]; P = .007) postoperatively. The AMH increased not significantly between the third and sixth months in group 1 (+9.4%). Six months after surgery, AMH was reduced by 59.3% compared to baseline values in group 1 ( P = .012), and by 29.5% in group 2 ( P = .200). A significant difference in the AMH decrease was present between bilateral and monolateral endometriomas ( P = .006). There was no correlation between the reduction rate of AMH and the number of follicles inadvertently removed in patients with endometriomas ( P = .669). In conclusion, AMH decreases significantly after surgical excision of ovarian endometriomas. The postoperative decrease does not appear to correlate with the amount of ovarian tissue inadvertently excised with the endometrioma wall.
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Affiliation(s)
- Ludovico Muzii
- Department of Obstetrics and Gynecology, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Di Tucci
- Department of Obstetrics and Gynecology, “Sapienza” University of Rome, Rome, Italy
| | | | - Giulia Galati
- Department of Obstetrics and Gynecology, “Sapienza” University of Rome, Rome, Italy
| | - Irene Pecorella
- Department of Pathology, “Sapienza” University of Rome, Rome, Italy
| | - Antonio Radicioni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, “Sapienza” University of Rome, Rome, Italy
| | - Antonella Anzuini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, “Sapienza” University of Rome, Rome, Italy
| | | | - Felice Patacchiola
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
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Henes M, Engler T, Taran FA, Brucker S, Rall K, Janz B, Lawrenz B. Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. ACTA ACUST UNITED AC 2019; 14:1745506518778992. [PMID: 29806554 PMCID: PMC5974568 DOI: 10.1177/1745506518778992] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Previous publications suggest a reduction in the ovarian reserve following ovarian surgery. The influence of the underlying disease, histology, size of the ovarian cyst and type of procedure remains unclear. The aim of this study was to investigate the influence of an ovarian operation on the ovarian reserve, based on the anti-Müllerian hormone levels. The anti-Müllerian hormone values were determined by means of a standardized enzyme-linked immunosorbent assay. In total, 52 patients with one or more ovarian cysts of different histologic entities treated at the Department of Women’s Health at the Women’s University Hospital in Tübingen were included in the study. Anti-Müllerian hormone was determined before and after surgery. The patients were 28 (range = 18–40) years old on average. There was a statistically significant decrease in anti-Müllerian hormone from 3.94 ± 3.18 to 3.14 ± 2.57 ng/mL (p = 0.001). In 80.8%, the cysts were unilateral, and in over 90.4%, a complete cyst extirpation was performed. A statistically significant reduction was seen in follicular cysts (4.72 ± 3.84 to 3.76 ± 2.91 ng/mL; p = 0.039) and endometriosis cysts (2.55 ± 1.87 to 1.72 ± 1.39 ng/mL; p = 0.024). Also, the size of the cysts had an influence on the ovarian reserve, only larger ovarian cysts with a diameter of 5 cm or more showed a statistically significant reduction in anti-Müllerian hormone. Our data showed a significant decrease in anti-Müllerian hormone levels after surgery on the ovaries. If this results in a long-term reduced ovarian reserve or is merely a short-term reaction to the procedure needs to be clarified. However, concerning young women, the indication of surgery should be given cautiously as—at least temporarily—a reduction in the ovarian reserve can occur.
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Affiliation(s)
- Melanie Henes
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Tobias Engler
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Florin-Andrei Taran
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Sara Brucker
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Katharina Rall
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | | | - Barbara Lawrenz
- 1 Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
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11
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Alammari R, Lightfoot M, Hur HC. Impact of Cystectomy on Ovarian Reserve: Review of the Literature. J Minim Invasive Gynecol 2017; 24:247-257. [DOI: 10.1016/j.jmig.2016.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 12/15/2016] [Accepted: 12/16/2016] [Indexed: 12/11/2022]
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