scholarly journals The impact of previous ovarian surgery on ovarian reserve in patients with endometriosis

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Hsin-Ju Chiang ◽  
Pin-Yao Lin ◽  
Fu-Jen Huang ◽  
Fu-Tsai Kung ◽  
Yu-Ju Lin ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
The Impact ◽  
Ovarian Surgery

O-057 The impact of diagnosis endometriosis as part of the fertility workup

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J A Garcia-Velasco
Keyword(s):  
Fertility Preservation ◽  
Ovarian Reserve ◽  
Time To Pregnancy ◽  
Her Family ◽  
Potential Damage ◽  
Changes Over Time ◽  
The Impact ◽  
Late Stages ◽  
Ovarian Surgery

Abstract Abstract text The impact of diagnosis endometriosis as part of the Fertility workup Endometriosis is a multifaceted disease that may go from completely asymptomatic to a debilitating condition with severe pelvic pain complicated infertility. In the last few years, how we approach fertility in women with endometriosis has clearly changed, postponing definitive/radical surgery till the patient has completed her family. As a clear association exists with endometriosis and infertility, during the fertility workup it is one of the diseases to investigate, as it may have been missed in previous annual gynecologic checkups. Here we may face two problems: a) the stigma of diagnosis a young women with the label “endometriosis”, as she may be under the pressure of a progressive disease that may or may not affect her quality of life, and b) if the diagnosis of endometriosis is positive, how this may affect the decision making process during the fertility journey. In this lecture we will discuss the difficulties of early diagnosis of endometriosis, why most of the previous test have failed, and the new opportunity that miRNAs seem to offer. Once endometriosis is diagnosed –early or late stages- how this may affect spontaneous chances of pregnancy, ovarian reserve, oocyte and embryo quality, endometrial receptivity, and last but not least, time to pregnancy. Obviously, the prognosis changes over time, and women’s age will be conditioning most of our decisions. We will try to identify whom to treat, to increase the absolute pregnancy rate, and when to treat, to reduce the time to pregnancy. Finally, we will discuss the opportunity of fertility preservation in this particular subgroup of women. Being aware of the potential damage that endometriosis by itself, or the associated ovarian surgery, may inflict on ovarian reserve make these women more proactive for fertility preservation.

scholarly journals The effect of prophylactic bilateral salpingectomy on ovarian reserve in patients who underwent laparoscopic hysterectomy

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Shizhuo Wang ◽  
Jiahui Gu
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Reserve ◽  
Premenopausal Women ◽  
Laparoscopic Hysterectomy ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Control Group ◽  
Significant Difference ◽  
Bilateral Salpingectomy ◽  
The Impact

Abstract Background Bilateral salpingectomy has been proposed to reduce the risk of ovarian cancer, but it is not clear whether the surgery affects ovarian reserve. This study compares the impact of laparoscopic hysterectomy for benign disease with or without prophylactic bilateral salpingectomy on ovarian reserve. Methods Records were reviewed for 373 premenopausal women who underwent laparoscopic hysterectomy with ovarian reserve for benign uterine diseases. The serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and three-dimensional antral follicle count (AFC) were assessed before surgery and 3 and 9 months postoperatively to evaluate ovarian reserve. Patients were divided into two groups according to whether they underwent prophylactic bilateral salpingectomy. The incidence of pelvic diseases was monitored until the ninth month after surgery. Results There was no significant difference between the two surgery groups in terms of baseline AMH, E2, FSH, LH, and AFC (all P > 0.05). There was no difference in potential bias factors, including patient age, operative time, and blood loss (all P > 0.05). There was also no significant difference between the two groups 3 months after surgery with respect to AMH (P = 0.763), E2 (P = 0.264), FSH (P = 0.478), LH (P = 0.07), and AFC (P = 0.061). Similarly, there were no differences between groups 9 months after surgery for AMH (P = 0.939), E2 (P = 0.137), FSH (P = 0.276), LH (P = 0.07) and AFC (P = 0.066). At 9 months after the operation, no patients had malignant ovarian tumors. The incidences of benign ovarian tumors in the salpingectomy group were 0 and 2.68 % at 3 and 9 months after surgery, respectively, and the corresponding values in the control group were 0 and 5.36 %. The incidences of pelvic inflammatory disease in the salpingectomy group were 10.72 and 8.04 % at 3 and 9 months after surgery, respectively, while corresponding values in the control group were 24.13 and 16.09 %. Conclusions Prophylactic bilateral salpingectomy did not damage the ovarian reserve of reproductive-age women who underwent laparoscopic hysterectomy. Prophylactic bilateral salpingectomy might be a good method to prevent the development of ovarian cancer. Larger clinical trials with longer follow-up times are needed to further evaluate the risks and benefits.

P–749 Knowledge of women undergoing surgery for endometrioma regarding the impact of the disease and its treatment on ovarian reserve and fertility

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M Horan ◽  
L Glover ◽  
P Downey ◽  
M Wingfield
Keyword(s):  
Ovarian Reserve ◽  
Negative Impact ◽  
Histological Diagnosis ◽  
Ovarian Cysts ◽  
Medical Setting ◽  
Future Fertility ◽  
Group 2 ◽  
Ovarian Endometriomas ◽  
The Impact ◽  
Group 1

Abstract Study question Do women undergoing surgery for endometrioma due to pain, a cyst and/or subfertility understand the impact of the disease and its treatment on ovarian reserve and fertility. Summary answer The majority of women treated in a fertility setting are well informed compared to those in a general medical setting. What is known already: Infertility affects 30% to 50% of women with endometriosis. Ovarian endometriomas are reported in 17–44% of infertile women with endometriosis and are typically associated with more severe disease. Endometriomas are associated with diminished ovarian reserve, due to the endometrioma per se or due to surgical interventions required to treat and excise the disease. ESHRE guidelines recommend that women should be informed pre-operatively of the potential reduction in ovarian reserve associated with surgery and that ovarian reserve tests should be performed when future fertility is a concern. Study design, size, duration In conjunction with our histopathology colleagues we identified a cohort of women with a histological diagnosis of one or more ovarian endometriomas who underwent surgery in our unit between 2010 and 2019. We developed a scoping questionnaire, targeted at women currently over the age of 40, who had previously undergone surgery for endometrioma under the age of 35. Patients were contacted by telephone and consent obtained to send an email with a survey link. Participants/materials, setting, methods We identified 47 women who had a histological diagnosis of endometrioma. Of these, 30 were contactable by telephone, of whom 29 consented to being sent information regarding the study and a link to the questionnaire. 21 women completed the survey. Respondents were divided into 2 groups for analysis. Group 1 cited ‘fertility’ or ‘both pain and fertility’ as an indication for their surgery while group 2 had ‘pain’ or ‘ovarian cysts’ but no fertility concerns. Main results and the role of chance: The majority (62%) of patients were diagnosed with endometriosis while aged 25–34. The indication for surgery was evenly divided between pain (32%), fertility (37%) and ovarian cysts (37%). 60% of women reported having endometriomas diagnosed preoperatively. Striking differences were noted between groups 1 and 2. Of the women who cited ‘fertility’ or ‘both pain and fertility’ (n = 9) as an indication for their surgery, 78% (n = 7) reported being aware of any possible negative impact of endometriosis on their fertility, with 78% also being aware of the possible negative impact of surgery for endometriosis on their fertility. This compared to only 36% (n = 4) and 27% (n = 3) respectively in Group 2. In group 1, 56% (n = 5) remembered having an AMH level checked pre operatively while 78% (n = 7) also had an ultrasound pre-operatively. In contrast, only 33% (n = 3) of Group 2 remember having an AMH level checked pre operatively though 64% (n = 7) had an ultrasound pre-operatively. Of those whose surgery was performed by a fertility specialist, 75% (n = 6) reported being aware of the impact of endometriosis and also the impact of surgery on ovarian reserve, compared to 44% (n = 4) of those who surgery was performed by a non-fertility specialist. Limitations, reasons for caution This is a retrospective study and the numbers are small. We were only able to identify women with an endometrioma via pathology records, so those with no excision of disease (eg those who had ablation of an endometrioma) were excluded from this analysis. Wider implications of the findings: This suggests the majority of patients treated in a fertility setting are counselled regarding the benefit of surgery but also the risk to ovarian reserve. This is not the case in other settings. It is time to disseminate guidelines such as those produced by ESHRE to our general gynaecology colleagues. Trial registration number Not applicable

scholarly journals Anti-Mullerian Hormone (AMH) Level in Presence of Ovarian Endometrioma

2021 ◽  
pp. 71-85
Author(s):  
Nesma F. Radwan ◽  
Ahmed M. El Khyat ◽  
Adel E. El Gergawy ◽  
Hesham A. Salem
Keyword(s):  
Ovarian Reserve ◽  
Harmful Effect ◽  
University Hospital ◽  
Control Group ◽  
Rapid Decline ◽  
Statistical Significant Difference ◽  
Female Patients ◽  
Significant Difference ◽  
Group B ◽  
The Impact

Background: The effect of endometriomas itself on the ovarian responsiveness that relate to ovarian reserve had been reported with several inconsistent results. In one study evaluated women with unilateral endometriomas, ovaries with disease showed lower response to ovarian stimulation than contralateral healthy ovaries .However, recent study on infertile women with un-operated unilateral small endometriomas did not support difference in ovarian responsiveness. The aim was to evaluate the impact of presence of endometriomas on ovarian reserve as measured by circulating AMH. Methods: This retrospective study was carried out on 80 female patients in childbearing period attending outpatient clinic and/or inpatient department of obstetrics and gynecology at Tanat University Hospital and the study was conducted directly after approval in the period from Apri, 2019 till April 2020. Group (A): Study group: 60 female patients aged between 20 to 30 years old GROUP (B): Control group: 20 age matched female with healthy ovaries. Results: there is no statistical significant difference between groups as regard Menarche (years), Regularity and Amount of menstrual blood flow. There is statistical significant difference between groups as regard fixed tender Right Ventricular Failure. But there are no statistical significant differences between groups as regard nodule in rectovaginal septum, fixed tender adnexal masses, association with adenomyosis and infertility. There is highly statistical significant difference between case and control groups as regard AMH levels. there are highly statistical significant positive correlation between duration of endometriosis and each of presence of pelvic pain, cyst diameter and Visual Analogue Scale. Conclusions:    Women with endometrioma have significantly lower serum AMH levels and seem to experience a more rapid decline in serum AMH levels than age matched counterparts, suggesting a harmful effect of endometrioma per se on ovarian reserve.

The impact of immunomodulating drugs on ovarian reserve in multiple sclerosis patients

2008 ◽  
Vol 90 ◽  
pp. S259
Author(s):  
A.P. Cil ◽  
A. Leventoglu ◽  
G. Yildiz ◽  
R. Soylukoc ◽  
K. Oktay
Keyword(s):  
Multiple Sclerosis ◽  
Ovarian Reserve ◽  
Multiple Sclerosis Patients ◽  
The Impact ◽  
Immunomodulating Drugs

Does size matter in females? An overview of the impact of the high variation in the ovarian reserve on ovarian function and fertility, utility of anti-Müllerian hormone as a diagnostic marker for fertility and causes of variation in the ovarian reserve in cattle

2011 ◽  
Vol 23 (1) ◽  
pp. 1 ◽  
Author(s):  
J. J. Ireland ◽  
G. W. Smith ◽  
D. Scheetz ◽  
F. Jimenez-Krassel ◽  
J. K. Folger ◽  
...  
Keyword(s):  
Young Adult ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Negative Impact ◽  
Critical Role ◽  
Diminished Ovarian Reserve ◽  
Maternal Environment ◽  
Adult Cattle ◽  
Size Matter ◽  
The Impact

The mechanism whereby the inherently high variation in ovary size and the total number of high-quality oocytes in ovaries (ovarian reserve) impact on ovarian function and fertility, diagnostics to measure the size of the ovarian reserve and the factors that cause variation in the ovarian reserve are unknown. Our results show that cattle can be phenotyped reliably based on the number of antral follicles growing during follicular waves (antral follicle count, AFC). Young adult cattle with a consistently low v. a high AFC have smaller gonads, a markedly diminished ovarian reserve and many other phenotypic characteristics usually associated with ovarian aging and infertility. A powerful new approach based on a single measurement of serum concentration of anti-Müllerian hormone (AMH) is described to test the longstanding hypothesis that the size of the ovarian reserve is positively associated with fertility. Also, new evidence shows that maternal environment has a critical role in regulation of the high variation in the ovarian reserve and perhaps fertility in offspring. These results support the conclusion that the inherently high variation in the ovarian reserve, potentially caused by alterations in the maternal environment, has a negative impact on ovarian function that may result in suboptimal fertility in young adult cattle, and a single AMH measurement can be used reliably in future studies to determine if fertility is suboptimal in young adult cattle with low circulating AMH concentrations and a correspondingly diminished ovarian reserve.

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