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

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.

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

10.21203/rs.3.rs-230207/v1 ◽

2021 ◽

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%. Conclusion 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.

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

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1931081 ◽

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.

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Evaluation of serum anti-Mullerian hormone levels in women with Hashimoto thyroiditis in the reproductive age

10.21203/rs.3.rs-39440/v1 ◽

2020 ◽

Author(s):

Ilknur Ozturk Unsal ◽

Sema Hepsen ◽

Pinar Akhanli ◽

Murat Calapkulu ◽

Muhammed Erkam Sencar ◽

...

Keyword(s):

Ovarian Reserve ◽

Thyroid Autoimmunity ◽

Premenopausal Women ◽

Hashimoto Thyroiditis ◽

Reproductive Age ◽

Control Group ◽

Autoimmune Thyroid ◽

High Prevalence ◽

Healthy Control ◽

Antibody Levels

Abstract Background Autoimmune thyroid disease in women is associated with subfertility and early pregnancy loss, and patients with primary ovarian insufficiency have a high prevalence of thyroid autoimmune disorders. The aim of this study was to investigate the association between Hashimoto thyroiditis and ovarian reserve. Methods Levels of serum thyroid stimulating hormones, thyroid autoantibodies, and anti-Mullerian hormone (AMH) were measured in women with Hashimoto thyroiditis (HT) and a healthy control group between 2018 and 2019. Result Evaluation was made of 108 premenopausal women with Hashimoto thyroiditis. A control group was formed of 172 healthy female subjects with normal anti-thyroid antibody levels and thyroid function. Serum AMH levels were determined to be significantly lower in the HT group compared to the control group. Conclusion Ovarian reserve evaluated by serum AMH concentration is affected by thyroid autoimmunity independently of anti-thyroid antibodies type or titers.

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Study of leucine-rich alpha-2-glycoprotein-1 marker serum level in cases of malignant epithelial ovarian tumors

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205747 ◽

2020 ◽

Vol 10 (1) ◽

pp. 12

Author(s):

Abd Elfatah Agameia ◽

Rania Shafik Swelem ◽

Hossam Hassan El Sokkary ◽

Ghada Shehata Elsayed

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Tumor Marker ◽

Histopathological Examination ◽

Mean Value ◽

Ovarian Tumors ◽

Controlled Study ◽

Control Group ◽

Group I ◽

Significant Difference

Background: The aim of this study was to compare the level of LRG1 in epithelial ovarian cancer (EOC) cases with benign ovarian masses and to evaluate results in relation to CA125.Methods: An observational prospective controlled study was done on 70 patients admitted to El Shatby Maternity University Hospital, Oncology department categorized as follows: study group (group I) included 35 patients, with epithelial ovarian malignancy confirmed by histopathological examination and control group (group Il) included 35 patients with benign ovarian tumors confirmed by histopathological examination. Determination of Serum LRGI level by using enzyme-linked immuno sorbent assay with CA125 tumor marker analysis were done for all cases of both groups.Results: As regard comparison between the two studied groups according to CA125 and LRGI. CA125 in group I ranged from 14.90 to 4600 with a mean value 856.73±1104.03, in group II ranged from 7.45 to 523 with a mean value of 51.97±86.14. LRGI in group I ranged from 62.46 to 653.98 with a mean value of 130.86±119.78, in group Il ranged from 47.73 to 261.78 with a mean value of 77.35±38.75. There was statistically significant difference between the two studied groups regarding CA125 and LRGI (p≤0.05).Conclusions: LRG1 can be used as promising tumor marker to diagnose epithelial malignant ovarian cancer with or without CA125 tumor marker as it was significantly higher in epithelial ovarian cancer patients.

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Comparison of Postoperative Ovarian Reserve Function Following Laparoscopic Hysterectomy and Laparoscopic Myomectomy: A Prospective Comparative Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10143077 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3077

Author(s):

Hye-Yon Cho ◽

Min Sun Kyung

Keyword(s):

Pilot Study ◽

Adverse Effects ◽

Ovarian Reserve ◽

Baseline Level ◽

Premenopausal Women ◽

Laparoscopic Hysterectomy ◽

Laparoscopic Myomectomy ◽

Baseline Levels ◽

The Impact

This prospective study aimed to investigate the impact of laparoscopic hysterectomy (LH) and laparoscopic myomectomy (LM) on ovarian reserve by comparing serum anti-Mullerian hormone (AMH) changes following surgery. Serum AMH levels were measured preoperatively (AMH0), and 7 days (AMH1), 2 months (AMH2), and 6 months (AMH3) after LH and LM in 79 premenopausal women (LH = 59; LM = 20). AMH0, AMH1, AMH2, and AMH3 were significantly higher in the LM group than in the LH group (p = 0.012, 0.001, 0.001, and 0.015, respectively). Since there are differences in indications between myomectomy and hysterectomy, logically, women who underwent myomectomy were younger and had higher AMH baseline levels. In addition, AMH changes at 7 days postoperatively from the baseline level were significantly decreased in the LH group compared to those in the LM group (p = 0.042). However, AMH changes at 2 months and 6 months postoperatively, compared to the baseline level, were not different between the two groups (p = 0.053 and 0.752, respectively). Moreover, the significant decrease in AMH (more than 60% decrease from the baseline level) was not different at 7 days, 2 months, and 6 months postoperatively between the two groups (p = 0.415, 487, and 0.364, respectively). Our data suggest that serum AMH levels were significantly decreased directly after LH, which suggests that LH may have adverse effects on ovarian reserve. However, mid-term follow-up showed that the damaged ovarian reserve in women who underwent LH may be partially restored in 6 months.

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THE SPECIFICITY OF THE OVARIAN RESERVE OF WOMEN WITH CHRONIC SALPINGOOPHORITIS

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-6-119-126 ◽

2018 ◽

Vol 25 (6) ◽

pp. 119-126

Author(s):

V. A. Novikova ◽

F. R. Autleva ◽

A. A. Sorochenko ◽

D. I. Fayzullina ◽

E. V. Nurgalieva

Keyword(s):

Ovarian Reserve ◽

Reproductive Period ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Regression Equations ◽

Women Of Reproductive Age ◽

Antral Follicles ◽

Preconception Consultation ◽

The Impact

Aim. The research was conducted for the assessment of the impact of chronic salpingoophoritis on the ovarian reserve of women in various phases of reproductive age.Materials and methods. A prospective, controlled and open cohort study was performed in 2013-2018 (n=202). The main group consisted of women with chronic salpingoophoritis (ChrSO) who applied for preconception consultation (n=138). In accordance with the reproductive age phase, the main group was divided into subgroups: the early reproductive age period (ERP, n=44), the peak reproductive age period (PRP, n=56), the late reproductive period (LRP, n=38). The control group consisted of conditionally healthy women of reproductive age (n=64). The ovarian reserve (OR) was estimated on the basis of the serum level of antimullerian hormone (AMH), inhibin B, estradiol, follicle stimulating hormone (FSH), an ultrasoundbased assessment of the number of antral follicles (AF), and the ovarian volume. Results. The age of women ranged from 18 to 40 years. Based on the discriminant analysis, it was found that the main indicators determining the specificity of the OR in ChrSO, depending on the phase of reproductive age, are the number of antral follicles, estradiol level and AMH (Wilks’ lambda = 0.35503, p<0.0001). The specificity of the OR of women with ChrSO (difference from the control group), regardless of the phase of reproductive age, initially and when evaluated after 6 months, is determined by the number of AF and the level of estradiol and AMH; the number of AF and AMH is determined with a similar estimate after 12 months. The specificity of the OR in ChrSO, which is dependent on the reproductive age phase, has been proved through the analysis with the neural networks training(the proportion of correct answers is more than 80%). The linear relationships were established between the values of each OR parameter in women with ChrSO. Initially, when estimating after 6 and 12 months, linear regression equations were calculated, allowing the values of individual OR parameters to be calculated over 6 and 12 months.Conclusion. Chronic salpingoophoritis (ChrSO) is associated with a decrease in ovarian reserve in women of reproductive age. The effect of ChrSO on some parameters of the ovarian reserve depends on the age phase of the reproductive period, which increases with time (after 6, 12 months). The presence of ChrSO in women planning future pregnancies requires preventive and therapeutic measures aimed at preserving the ovarian reserve and the preferred implementation of fertility in early reproductive age before the ovarian reserve starts to decline.

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Evaluation of serum anti-Mullerian hormone levels in women with Hashimoto thyroiditis in the reproductive age

10.21203/rs.3.rs-39440/v2 ◽

2020 ◽

Author(s):

Ilknur Ozturk Unsal ◽

Sema Hepsen ◽

Pinar Akhanli ◽

Murat Calapkulu ◽

Muhammed Erkam Sencar ◽

...

Keyword(s):

Ovarian Reserve ◽

Thyroid Autoimmunity ◽

Premenopausal Women ◽

Hashimoto Thyroiditis ◽

Reproductive Age ◽

Control Group ◽

Autoimmune Thyroid ◽

High Prevalence ◽

Healthy Control ◽

Antibody Levels

Abstract Background: Autoimmune thyroid disease in women is associated with subfertility and early pregnancy loss, and patients with primary ovarian insufficiency have a high prevalence of thyroid autoimmune disorders. The aim of this study was to investigate the association between Hashimoto thyroiditis (HT) and ovarian reserve.Methods: Levels of serum thyroid stimulating hormones, thyroid autoantibodies, and anti-Müllerian hormone (AMH) were measured in women with HT and a healthy control group between 2018 and 2019. Result: Evaluation was made of 108 premenopausal women with HT. A control group was formed of 172 healthy female subjects with normal anti-thyroid antibody levels and thyroid function. Serum AMH levels were determined to be significantly lower in the HT group compared to the control group.Conclusion: Ovarian reserve evaluated by serum AMH concentration is affected by thyroid autoimmunity independently of anti-thyroid antibodies type or titers.

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Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

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Features of the ovarian reserve of women of reproductive age suffering from autoimmune diseases

GYNECOLOGY ◽

10.26442/20795696.2020.5.200416 ◽

2020 ◽

Vol 22 (5) ◽

pp. 27-30

Author(s):

Elena N. Andreeva ◽

Olga R. Grigoryan ◽

Yulia S. Absatarova ◽

Irina S. Yarovaya ◽

Robert K. Mikheev

Keyword(s):

Type 1 Diabetes ◽

Thyroid Gland ◽

Autoimmune Diseases ◽

Ovarian Reserve ◽

Reproductive Potential ◽

Reproductive Age ◽

Control Group ◽

Antithyroid Antibodies ◽

Healthy Women

The reproductive potential of a woman depends on indicators of the ovarian reserve, such as the anti-Muller hormone (AMH) and the number of antral follicles (NAF). Autoimmune diseases have a significant effect on fertility and contribute to the development of premature ovarian failure. Aim.To evaluate the parameters of the ovarian reserve in patients with type 1 diabetes mellitus, carriers of antibodies to the thyroid gland in a state of euthyroidism and compare them with similar parameters in healthy women. Materials and methods.In the first block of the study, the level of AMH, follicle-stimulating hormone, luteinizing hormone, NAF was studied among 224 women with diabetes and 230 healthy women in the control group. In block II, the level of the above hormonal indices was studied in 35 carriers of antithyroid antibodies in the state of euthyroidism and 35 healthy women. Results.In patients with type 1 diabetes, the level of AMH, NAF was statistically significantly lower when compared with the control group. Among carriers of antithyroid antibodies and healthy women, no difference in AMH and NAF was found. Conclusion.The autoimmune processes accompanying diabetes are more influenced by the ovarian reserve indices than autoimmune aggression to the tissues of the thyroid gland.

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The Antioxidant Effect of Curcumin and Rutin on Oxidative Stress Biomarkers in Experimentally Induced Periodontitis in Hyperglycemic Wistar Rats

Molecules ◽

10.3390/molecules26051332 ◽

2021 ◽

Vol 26 (5) ◽

pp. 1332

Author(s):

Gilda M. Iova ◽

Horia Calniceanu ◽

Adelina Popa ◽

Camelia A. Szuhanek ◽

Olivia Marcu ◽

...

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Diabetic Rats ◽

Gingival Tissue ◽

Control Group ◽

Albino Rats ◽

Oxidative Stress Biomarkers ◽

Significant Difference ◽

The Impact ◽

Experimentally Induced

Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.

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