Influence of surgical treatment of ovarian endometriomas cysts on ovarian reserve in women of reproductive age

The objective: of the study was to investigate the indicators of ovarian reserve in infertile women of reproductive age with non-operated ovarian endometriomas more than 3 cm in diameter. Patients and methods. It were examined 63 patients of reproductive age with ovarian endometriosis, including 33 with unilateral ones and 30 with bilateral. The control group consisted of 30 conditionally somatically healthy women of reproductive age with secondary tubal infertility, with regular ovulatory menstrual cycle. All the women were operated on. Prior to the surgery it were studied biochemical and sonographic markers of ovarian reserve, and after pathological study of operational materials – histological markers. Results. It was registered decrease in biochemical, ultrasonographic and histological indicators of ovarian reserve compared to control. Conclusion. The authors conclude that endometriosis directly affects ovarian reserve and ovarian reserve should be assessed not only after it, but before surgery in women with endometriomas and reproductive disorders. It is important to determine the tactics of their management. Key words: endometrioma, ovary, ovarian reserve, operation, Anti-Mьllerian hormone, inhibin B, FSH, estradiol, the number of antral follicles.

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Clinical and sonological features in endometriomas in women of reproductive age

HEALTH OF WOMAN ◽

10.15574/hw.2016.114.85 ◽

2016 ◽

pp. 85-89

Author(s):

О. Shapoval ◽

Keyword(s):

Endometrial Hyperplasia ◽

Benign Tumor ◽

Pain Syndrome ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Ovarian Endometriosis ◽

Gynecological Examination ◽

Different Characteristics ◽

Ovarian Endometriomas

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.

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INFLUENCE OF SURGICAL INTERVENTION ON PATIENTS WITH OVARIAN APOPLEXY IN THE ASPECT OF OVARIAN RESERVE PRESERVATION

World Science ◽

10.31435/rsglobal_ws/31052019/6512 ◽

2019 ◽

Vol 2 (5(45)) ◽

pp. 7-10

Author(s):

O. M. Ishchak

Keyword(s):

Surgical Treatment ◽

Ovarian Reserve ◽

Antral Follicle ◽

Disease Recurrence ◽

Reproductive Age ◽

Hemodynamic Parameters ◽

Bipolar Coagulation ◽

Study Results ◽

Duration Of Surgery ◽

First Time

Ovarian apoplexy is the women’s disease of reproductive age, 75% of which are under the age of 30 years old, about 30% undergo surgery, and 40-62% of them are subjected to repeated surgeries because of disease recurrence [3, 10]. Goal of study: improvement of surgical treatment of the patients with ovarian apoplexy for maximal preservation of ovarian reserve.Materials and methods. A total of 120 women were included in the study. These include 55 patients with ovarian apoplexy, who underwent laparoscopic surgery for the first time. These patients were included in the prospective study and divided into two groups, depending on the hemostasis method used during the surgery. Group 1 included 30 patients with hemostasis, which was carried out using bipolar coagulation, group 2 included 25 patients, whose bleeding from the ovary was stopped by applying sutures. In each group, the patients were selected with the “blind” method. The study included patients with stable hemodynamic parameters before surgery and duration of hospitalization of not more than 24 hours. The comparison group consisted of 45 patients with laparoscopic confirmation of pain form of the ovarian apoplexy, who underwent conservative treatment. Study results and their discussion. Patients with ovarian apoplexy with stable hemodynamic parameters should undergo surgery using laparoscopic access, which allows to clarify the diagnosis, stop bleeding, prevent development of sexually transmitted infections and carry out surgical correction of the associated pathological processes of the internal genital organs. Stop of bleeding at the patients with ovarian apoplexy with bipolar electrosurgery is faster (shorter duration of surgery by 13 minutes), but this leads to more significant decrease in ovarian reserve (Anti-Mullerian hormone (AMH) by 30%, antral follicle count (AFC) by 10%) than use of hemostatic sutures (AMH by 22%, PAF by 8%) (p <0.05). In order to maximize the maintenance of the ovarian reserve at surgeries by women with ovarian apoplexy, it is always better to carry out hemostasis by enucleating the cyst capsule within healthy tissues and saturation with absorbable synthetic areactive sutures on the ovarian wound following by intracorporal knot tying. Regardless of the hemostasis, used during surgical treatment of ovarian apoplexy by patients of the age of 36 years old and older, there is a greater decrease in ovarian reserve (AMH by 30%, AFC by 20%) than at patients whose age is less than 35 years old (AMH by 20%, AFC by 12%) (p <0.05). By patients with implemented fertility function regardless of age and by all patients under the age of 35, undergoing surgery because of ovarian apoplexy for the first time, bipolar coagulation is permissible to stop bleeding. At implementation of bipolar hemostasis of patients with ovarian apoplexy, point coagulation of bleeding vessels should be performed, avoiding damage to surrounding tissues.

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Ovarian Reserve in Young Women of Reproductive Age with Crohnʼs Disease

Inflammatory Bowel Diseases ◽

10.1002/ibd.21872 ◽

2012 ◽

Vol 18 (8) ◽

pp. 1515-1522 ◽

Cited By ~ 24

Author(s):

Thomas Fréour ◽

Charline Miossec ◽

Kalyane Bach-Ngohou ◽

Thomas Dejoie ◽

Mathurin Flamant ◽

...

Keyword(s):

Young Women ◽

Ovarian Reserve ◽

Reproductive Age ◽

Women Of Reproductive Age

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The effect of endometrioma on ovarian reserve

Journal of Medical Science ◽

10.20883/jms.2017.201 ◽

2017 ◽

Vol 86 (3) ◽

pp. 237

Author(s):

Małgorzata Agnieszka Szczepańska ◽

Paweł P. Jagodziński ◽

Ewa Wender‑Ożegowska

Keyword(s):

Ovarian Reserve ◽

Antral Follicle ◽

Antral Follicle Count ◽

Reproductive Age ◽

In Vitro Fertilisation ◽

Current State ◽

Ovarian Endometrioma ◽

State Of Research ◽

Ovarian Endometriomas

An ovarian endometrioma is a very common form of endometriosis in women of reproductive age. This review presents the current state of research on ovarian reserve in women with ovarian endometriomas. Endometrioma can negatively affect ovarian markers: the anti‑Müllerian hormone (AMH), antral follicle count (AFC) and in vitro fertilisation (IVF) results. Decisions on the surgical treatment of endometrial cysts should be carefully thought through, especially in women who have not given birth.

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Risk Factors Associated with Impaired Ovarian Reserve in Young Women of Reproductive Age with Crohn’s Disease

Intestinal Research ◽

10.5217/ir.2019.00103 ◽

2020 ◽

Vol 18 (2) ◽

pp. 200-209 ◽

Cited By ~ 1

Author(s):

Yue Zhao ◽

Baili Chen ◽

Yao He ◽

Shenghong Zhang ◽

Yun Qiu ◽

...

Keyword(s):

Risk Factors ◽

Crohn’S Disease ◽

Young Women ◽

Ovarian Reserve ◽

Disease State ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Factors Associated ◽

Active Disease

Background/Aims: Crohn’s disease (CD) primarily affects young female adults of reproductive age. Few studies have been conducted on this population’s ovarian reserve status. The aim of study was to investigate potential risk factors associated with low ovarian reserve, as reflected by serum anti-Müllerian hormone (AMH) in women of reproductive age with CD.Methods: This was a case-control study. Cases included 87 patients with established CD, and healthy controls were matched by age, height and weight in a 1:1 ratio. Serum AMH levels were measured by enzyme-linked immunosorbent assay.Results: The average serum AMH level was significantly lower in CD patients than in control group (2.47±2.08 ng/mL vs. 3.87±1.96 ng/mL, respectively, P<0.001). Serum AMH levels were comparable between CD patients and control group under 25 years of age (4.41±1.52 ng/mL vs. 3.49±2.10 ng/mL, P=0.06), however, serum AMH levels were significantly lower in CD patients over 25 years of age compared to control group (P<0.05). Multivariable analysis showed that an age greater than 25 (odds ratio [OR], 10.03; 95% confidence interval [CI], 1.90–52.93, P=0.007), active disease state (OR, 27.99; 95% CI, 6.13–127.95, P<0.001) and thalidomide use (OR, 15.66; 95% CI, 2.22–110.65, P=0.006) were independent risk factors associated with low ovarian reserve (serum AMH levels <2 ng/mL) in CD patients. Conclusions: Ovarian reserve is impaired in young women of reproductive age with CD. Age over 25 and an active disease state were both independently associated with low ovarian reserve. Thalidomide use could result in impaired ovarian reserve.

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Experience of treatment of endometriosisrelated pneumothorax

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2017-176-3-56-60 ◽

2017 ◽

Vol 176 (3) ◽

pp. 56-60

Author(s):

V. G. Pishchik ◽

A. D. Obornev ◽

M. A. Atyukov ◽

A. S. Petrov ◽

A. I. Kovalenko

Keyword(s):

Surgical Treatment ◽

Hormone Therapy ◽

Spontaneous Pneumothorax ◽

Pleural Cavity ◽

Reproductive Age ◽

Control Group ◽

Visual Examination ◽

Women Of Reproductive Age ◽

Course Of Disease

OBJECTIVE. The article analyzed the experience of treatment of endometriosis-related pneumothorax (ERP). MATERIAL AND METHODS. The diagnosis of ERP was detected in 30 women at the period from 2004 to 2015. A control group consisted of 149 women. RESULTS. Statistically significant differences associated with presence of ERP were the elder age, right-side localization and recurrence course of disease. Diaphragmatic fenestrations and endometriotic ectopy and their combinations were specific findings in ERP-group. This group of patients characterized by frequent recurrences and higher rate of complications. The most effective method of treatment of ERP was diaphragm resection with pleurectomy and hormone therapy from 3 to 6 months after surgery. CONCLUSIONS. Endometriosis-related pneumothorax could cause up to 34 % cases of spontaneous pneumothorax in women of reproductive age. Diaphragmatic fenestrations and endometriotic lesions were specific signs of EAP. Direct visual examination of the pleural cavity was inevitable for reliable diagnostics of the disease. Surgical treatment of ERP was determined by higher rates of complication and recurrence. Postoperative hormone therapy could significantly improve the results of surgical treatment of ERP.

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FUNCTION OF THE ONLY OVARY AFTER SURGICAL TREATMENT THE COMPLICATIONS OF BENIGN TUMORS AND TUMOR FORMATIONS OF OVARIES IN WOMEN OF REPRODUCTIVE AGE

EMERGENCY MEDICAL CARE ◽

10.24884/2072-6716-2017-18-1-34-38 ◽

2017 ◽

Vol 18 (1) ◽

pp. 34-38

Author(s):

D. M. Gasymova ◽

N. N. Rukhliada ◽

M. A. Melnikova

Keyword(s):

Surgical Treatment ◽

Reproductive Age ◽

Benign Tumors ◽

Women Of Reproductive Age

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Management of endometriosis-related infertility: Considerations and treatment options

Clinical and Experimental Reproductive Medicine ◽

10.5653/cerm.2019.02971 ◽

2020 ◽

Vol 47 (1) ◽

pp. 1-11 ◽

Cited By ~ 4

Author(s):

Dayong Lee ◽

Seul Ki Kim ◽

Jung Ryeol Lee ◽

Byung Chul Jee

Keyword(s):

Surgical Treatment ◽

Ovarian Reserve ◽

Intrauterine Insemination ◽

Treatment Options ◽

Oocyte Retrieval ◽

Reproductive Age ◽

Treatment Modalities ◽

Inflammatory Reactions ◽

Risk Of Cancer

Endometriosis is a common inflammatory disease in women of reproductive age and is one of the major causes of infertility. Endometriosis causes a sustained reduction of ovarian reserve through both physical mechanisms and inflammatory reactions, which result in the production of reactive oxygen species and tissue fibrosis. The severity of endometriosis is related to ovarian reserve. With regard to infertility treatment, medical therapy as a neoadjuvant or adjuvant to surgical therapy has no definite beneficial effect. Surgical treatment of endometriosis can lead to ovarian injury during the resection of endometriotic tissue, which leads to the deterioration of ovarian reserve. To overcome this disadvantage, a multistep technique has been proposed to minimize the reduction of ovarian reserve. When considering surgical treatment of endometriosis in patients experiencing infertility, it should be kept in mind that ovarian reserve can be reduced both due to endometriosis itself and by the process of removing endometriosis. In cases of mild- to moderate-stage endometriosis, intrauterine insemination with ovarian stimulation after surgical treatment may increase the likelihood of pregnancy. In cases of severe endometriosis, the characteristics of the patient should be considered in a multidisciplinary manner to determine the prioritization of treatment modalities, including surgical treatment and assisted reproduction methods such as in vitro fertilization. The risk of cancer, complications after pregnancy, and infection during oocyte retrieval should also be considered when making treatment decisions.

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