scholarly journals Epinephrine minimizes the use of bipolar coagulation and preserves ovarian reserve in laparoscopic ovarian cystectomy: a randomized controlled trial

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eun Young Park ◽  
Kyu-Hee Hwang ◽  
Ji-Hee Kim ◽  
San-Hui Lee ◽  
Kyu-Sang Park ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Function ◽  
Controlled Trial ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Histopathological Analysis ◽  
Bipolar Coagulation ◽  
Ovarian Cystectomy ◽  
Novel Method ◽  
Group Serum

AbstractWe 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.

scholarly journals Ovarian reserve in patients who have undergone endometriosis surgery

2018 ◽  
Vol 75 (7) ◽  
pp. 644-650
Author(s):  
Olivera Dzatic-Smiljkovic ◽  
Mladenko Vasiljevic ◽  
Ivana Rudic ◽  
Jelena Vugdelic ◽  
Aleksandar Ristic ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Function ◽  
Uterine Cavity ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Inhibin B ◽  
Ca 125 ◽  
Control Group ◽  
Study Group ◽  
Ovarian Volume

Background/Aim. Endometriosis is a gynaecological disorder characterized by the presence of endometrial tissue outside the uterine cavity. The aim of this paper was to determine the effect of laparoscopic cystotomy and cystectomy on ovarian function, as well as to compare these two methods in terms of qualitative and quantitative damage to the ovaries, achieved pregnancies and recurrence. Methods. The prospective study, conducted in ?Narodni Front? Obstetrics and Gynaecology Clinic in Belgrade at the Endoscopic Infertility Treatment Ward, included a total of 150 patients. The study group was represented by 100 patients who underwent a surgical treatment of endometrial ovarian cysts. The patients in the study group were divided into 2 subgroups: Subgroup I consisted of 50 patients who underwent a laparoscopic cystotomy (incision of the cyst and thermal coagulation) and subgroup II which included 50 women who underwent a laparoscopic cystectomy. The control group consised of patients who underwent a surgery due to tubal factor infertility. The following parameters of the ovarian function were tested: the ovarian volume, the antral follicle count, the presence of the preovulatory follicle on the operated ovary, the serum levels of anti- M?llerian hormone (AMH), follicle-stimulating hormone (FSH), ovarian tumor marker (Ca 125), inhibin B, as well as the rate of achieved pregnancies one year after the surgery. Results. The ovarian volume and the antral follicle count as well as the FSH values were significantly higher in the control group in comparison with the patients in the study group. There were no significant differences in the ovarian volume, the antral follicle count, the AMH values and inhibin B values in the study group between the patients with cystectomy and those with the incision and coagulation of the cyst. Conclusion. Both surgical techniques diminished the ovarian reserve: cystectomy was more aggressive method in terms of the damage inflicted on the ovarian tissue, and incision with coagulation carried a higher risk of recurrence.

scholarly journals Size of Endometrioma and Number does Influence the Ovarian Reserve: A Prospective Observational Study

2016 ◽  
Vol 7 (1) ◽  
pp. 14-18
Author(s):  
Pratap Kumar ◽  
MR Sandya
Keyword(s):  
Observational Study ◽  
Ovarian Reserve ◽  
Cyst Wall ◽  
Prospective Observational Study ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Histopathological Analysis ◽  
Laparoscopic Cystectomy ◽  
Endocrine Parameters ◽  
The Mean

ABSTRACT Background Endometriosis is one of the most commonly encountered benign problems in gynecology. Ultrasound and endocrine parameters have been widely accepted as markers of ovarian reserve. Anti-Mullerian hormone (AMH) in conjugation with antral follicle counts is now believed to be an excellent measure for detecting ovarian reserve. Surgical approach has a fundamental role in the management of endometriosis. The loss of normal follicles can be studied by histopathological assessment of the cyst wall. The postoperative decline in the ovarian reserve is believed to have a correlation with number of endometriomas and diameter of the cyst wall. Objective This prospective observational study was undertaken to evaluate the effect of laparoscopic cystectomy with respect to number and size of the cyst on ovarian reserve parameters. Materials and methods Fifty patients undergoing laparoscopic endometrioma cystectomy were analyzed. Cysts of <5cm and >5cm and the number of cysts were studied. Statistical analysis was done using Mauchly's test of sphericity. Anti-Mullerian hormone and antral follicle count were estimated prior to and 1 month after surgery. Pre- and postoperative values were compared and analyzed with respect to number and size of endometrioma. Observation and results There was an overall drop of AMH from 3.8 ± 3.01 to 2.67 ± 1.92 ng/ml (p < 0.001). The mean AMH in bilateral and unilateral endometrioma was 2.9 ± 1.7 and 3.9 ± 3.17 ng/ml respectively. Anti-Mullerian hormone dropped from 4.53 ± 3.4 to 3.19 ± 2.18 with <5 cm cyst compared with 2.4 ± 1.2 to 1.7 ± 0.85 with >5 cm cyst (p < 0.01). Overall drop in AFC was 5.17 ± 1.44 and 3.61 ± 1.61 pre- and postoperative respectively (p < 0.01). Mean drop in AFC was 2.2 and 1.2 in cyst <5 and > 5 cm respectively. Histopathological analysis showed loss of follicles in 25% of the cyst walls. This was correlating with the drop in both AMH and AFC postoperatively. Conclusion Size and number of cyst does affect ovarian reserve to the effect that smaller and bilateral cyst leads to a greater decline in the same. How to cite this article Sandya MR, Kumar P. Size of Endometrioma and Number does Influence the Ovarian Reserve: A Prospective Observational Study. Int J Infertil Fetal Med 2016;7(1):14-18.

scholarly journals Evaluation of the Ovarian Reserve in Women With Systemic Lupus Erythematosus

2021 ◽  
Author(s):  
Felipe Arturo Morales-Martínez ◽  
Celina Salas-Castro ◽  
Manuel Rolando. García-Garza ◽  
Otto Valdés-Martínez ◽  
Selene Marysol García-Luna ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Ovarian Reserve ◽  
Lupus Erythematosus ◽  
Ovarian Function ◽  
Autoimmune Disorder ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Pharmacological Treatments ◽  
Systemic Lupus ◽  
Normal Individuals

Objective: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder where the disease activity itself and the medications used for its treatment, may have adverse effects on ovarian function. This study aimed to assess the ovarian reserve (OR) in SLE patients. Materials and methods: The anti-müllerian hormone (AMH) and the antral follicle count (AFC), two markers to evaluate the OR was assessed in 64 SLE patients and compared to normal individuals. Additionally, we assessed whether the disease per se or the pharmacological treatments affect the OR. Results: Patients with SLE displayed alterations in the OR regardless of the presence of alterations of the menstrual cycle. The AFC and AMH were significantly lower in SLE patients with and without menstrual alterations when compared to control individuals (p<0.0001). However, the AFC and AMH levels were significantly correlated (p=0.006) in the SLE patients with menstrual alterations. Except for hydroxychloroquine that was statistically higher in SLE patients with menstrual alterations (p=0.04), the cumulative dose for cyclophosphamide, corticosteroid, and methotrexate was similar in SLE patients regardless of the occurrence of menstrual alterations. Conclusion: The monitoring of AMH and AFC in SLE patients should be used to detect the rapid and irreversible decline of the OR to provide a possibility of pregnancy to the SLE patients.

scholarly journals Urinary Bisphenol A Concentrations and Parameters of Ovarian Reserve among Women from A Fertility Clinic

2021 ◽  
Vol 18 (15) ◽  
pp. 8041
Author(s):  
Ewelina Czubacka ◽  
Bartosz Wielgomas ◽  
Anna Klimowska ◽  
Michał Radwan ◽  
Paweł Radwan ◽  
...  
Keyword(s):  
Bisphenol A ◽  
Ovarian Reserve ◽  
Animal Studies ◽  
Ovarian Function ◽  
Ion Trap ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Fertilization Rate ◽  
Reproductive Age ◽  
Study Participants

Background: Human exposure to environmentally widespread endocrine disruptors, especially bisphenol A (BPA), has been suggested to affect reproductive health. Animal studies indicate that BPA may play a role in the process of reproduction and impact on maturing oocytes, meiotic cell division or fertilization rate. Nevertheless, data regarding the effects of exposure to BPA on women’s ovarian function are still limited. Therefore, the aim of the current study is to assess the effects of environmental exposure to BPA on ovarian reserve. Methods: The study participants consisted of 511 women in reproductive age (25–39 years) who attended an infertility clinic for diagnosis, due to the couples’ infertility. BPA urinary concentrations were assessed by the validated gas chromatography ion-trap mass spectrometry method. The ovarian reserve was assessed using ovarian reserve parameters: Hormones concentrations: E2 (estradiol), FSH (follicle stimulating hormone), AMH (anti-Müllerian hormone), and AFC (antral follicle count). Results: In the present study, the negative association between BPA urinary concentrations and AMH (p = 0.02) and AFC (p = 0.03) levels was found. Exposure to BPA was not related to other examined parameters of ovarian reserve (FSH, E2). Conclusions: Our results suggest that BPA exposure may affect women ovarian reserve parameters and reduce ovarian reserve. As this is one of the first studies of its kind, the findings need confirmation in a further investigation.

scholarly journals Association between thyroid autoimmunity and ovarian reserve in women with hypothyroidism

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Felipe A. Morales-Martínez ◽  
Luis H. Sordia-Hernández ◽  
Martha Merino Ruiz ◽  
Selene Garcia-Luna ◽  
Otto H. Valdés-Martínez ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Function ◽  
Thyroid Autoimmunity ◽  
Antral Follicle ◽  
Serum Levels ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Autoimmune Hypothyroidism ◽  
Thyroid Hormone Concentration ◽  
The Impact

Abstract Background The ovarian function and therefore the ovarian reserve may be compromised by the pathogenesis of autoimmune diseases of which, Hashimoto’s thyroiditis (HT) is the most common in women of reproductive age. Furthermore, a prolonged reduction in thyroid hormone concentration results in a broad spectrum of reproductive alteration. Previous reports in the literature have been controversial regarding the impact of hypothyroidism and alterations in the ovarian reserve. Thus, this prospective and comparative study aimed to evaluate the association of hypothyroidism with low ovarian reserve. Materials and Methods A subset of 27 patients with primary autoimmune hypothyroidism were compared to healthy women. The ovarian reserve was assessed through the anti-Mullerian hormone (AMH) and the antral follicle count (AFC). Results Overall, the two groups did not display significant differences in length of their menstrual cycles neither in the AMH serum levels nor the AFC. Conclusions No significant alteration was found in the ovarian reserve of women with HT.

scholarly journals PHYSIOLOGY AND ENDOCRINOLOGY SYMPOSIUM: Anti-Müllerian hormone: a biomarker for the ovarian reserve, ovarian function, and fertility in dairy cows

2019 ◽  
Vol 97 (4) ◽  
pp. 1446-1455 ◽  
Author(s):  
Francesca Mossa ◽  
James J Ireland
Keyword(s):  
Dairy Cows ◽  
Ovarian Reserve ◽  
Maternal Nutrition ◽  
Ovarian Function ◽  
Bos Taurus ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Dairy Heifers ◽  
Follicular Waves ◽  
Heritable Trait

Abstract This review summarizes studies we conducted to test the hypothesis that size of the ovarian reserve (number of healthy follicles and oocytes in ovaries) positively impacts ovarian function and fertility in cattle. Key results, primarily in Bos taurus dairy cattle, show that antral follicle count (AFC) during follicular waves is highly variable between individuals, but very highly repeatable within individuals. Cycling heifers with low (≤15 follicles ≥3 mm, ~20% of a herd) vs. a high AFC (≥25, ~20% of a herd) have a smaller ovarian reserve, higher FSH but lower anti-Müllerian hormone (AMH), androstenedione, estradiol, and progesterone concentrations. Moreover, cattle with low AFC have a thinner endometrium, decreased response of granulosal, thecal, or luteal cells to FSH or LH and a poorer response to superovulation compared to cattle with high AFC. Interestingly, cows with a very high AFC as heifers have reduced fertility, fewer lactations, and shorter herd longevity, whereas cows with a low vs. intermediate AFC have reduced fertility, fewer lactations, and shorter herd longevity. Anti-Müllerian hormone concentrations are static within individuals but highly positively correlated with AFC, but fertility is not correlated with circulating AMH concentration in heifers and dairy cows with low vs. a higher AMH as heifers have reduced fertility and a shorter herd longevity. Anti-Müllerian hormone concentrations in dairy heifers are a moderately heritable trait (36%), and negatively impacted by inadequate maternal nutrition during early pregnancy or high maternal somatic cell count. We conclude that genetic or environmental manipulations of AMH could enhance size of the ovarian reserve and ovarian function, thereby improving fertility, response to superovulation, and longevity in dairy cows.

scholarly journals Effect of Ayurvedic Treatment Protocol on Diminishing Ovarian Reserve

2020 ◽  
Vol 11 (2) ◽  
pp. 228-234
Author(s):  
Divya U ◽  
Vijayakumar N
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Potential ◽  
Treatment Protocol ◽  
Antral Follicle ◽  
Poor Responder ◽  
Antral Follicle Count ◽  
In Vitro Fertilisation ◽  
Rank Test ◽  
Ayurvedic Treatment

Diminishing ovarian reserve (DOR) is a condition in which the ovary loses reproductive potential, compromising fertility. Nowadays 10-30% of female infertility is due to DOR and considered as “expected poor responder” for In vitro fertilisation (IVF).   Correlation of DOR can be done with Dathukshaya vandya (depletion or inadequate formation of dhatus) explained in Harithasamhita. The objective of the study was to evaluate the effect of Ayurvedic treatment protocol on Diminishing ovarian reserve. The study protocol includes- ashtachurna for deepana (appetiser), pachana (digestives) and kolakulathadi churna for udwarthana (powder massage). Sukumaragrutha used for snehapana (oral administration of medicated ghee), utharabasthi (intrauterine administration) and rasayana (rejuvenation therapy ). Danwantarathaila abhyanga (oleation) and ooshmasweda (sudation) done for 3 days. Sukumaraeranda was used for virechana (therapeutic purgation) and also Yogabasthi (medicated enema). The study design was pre and post interventional study with a sample size of 15 selected as per inclusion and exclusion criteria, conducted at hospital for women and children, Government Ayurveda College, Thiruvananthapuram. Assessment was based on Bologna criteria for DOR. The statistical techniques employed are Wilcoxon’s signed rank test and Paired t test. Results showed statistically significant effect on improving Antral follicle count (AFC) (p- 0.01), Estradiol (p- 0.005), conception (p- 0.014), on regulating amount of bleeding (p- 0.003), menstrual interval correction (p-0.001) and dyspareunia (p-0.005). But insignificant effect on improving Anti Mullerian Hormone (AMH) (p- 0.469) and regularising LH/FSH ratio (p-0.104) was found.

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