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 ◽  
...  

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.

2020 ◽  
Author(s):  
Lingnv Yao ◽  
Wenqin Lin ◽  
Nan Jiang ◽  
Chuyan Li ◽  
Haifeng Cao ◽  
...  

Abstract Background: To explore whether serum and follicular fluid Sirt1, Sirt2 can reflect ovarian reserve and predict the outcome of assisted reproduction. Methods: The study population comprised 125 patients , 39 in OPOI(occult form of premature ovarian insufficiency)group, 49 in advanced age group , and 37 in control group. The levels of serum Sirt1, Sirt2 were measured on the 2nd to 5th day of menstruation (bSirt1,bSirt2) and HCG day. Follicular fluid Sirt1 (FFSirt1) and Sirt2 (FFSirt2), were determined on OPU (oocyte pick up) day. Results: The level of FFSirt2 in the advanced age group was significantly lower than those in other two groups. FFSirt 2 and Sirt 2 (HCG day ) were negatively correlated with age (r=-0.35, r=-0.19), but there were no value of them for assessing DOR (diminished ovarian reserve). The level of bSirt2 in (cumulative) pregnant group was significantly higher (r=0.24, P=0.00). Conclusions: This was the first study to show that FFSirt2 and Sirt2 (HCG day) might be negatively correlated with age and antral follicle count (AFC). bSirt2 could predict cumulative pregnancy outcome together with anti-Mullerian hormone (AMH), AFC and age.


Author(s):  
Maria Francesca Messina ◽  
Tommaso Aversa ◽  
Giuseppina Salzano ◽  
Daria Costanzo ◽  
Concetta Sferlazzas ◽  
...  

AbstractPrimary gonadal failure may occur in most individuals with Turner syndrome (TS). Since ovaries in TS girls undergo premature apoptosis and cryopreservation of ovarian tissue is now feasible, it would be useful to identify a reliable marker of ovarian reserve in these patients. We planned to evaluate ovarian function in a group of TS patients by measuring both traditional markers and inhibin B and to compare these results with those of a control group.We enrolled 23 patients with TS and 17 age-matched healthy girls. The median age of our TS patients was 17.6 years. Three out of the 23 patients (13%) showed spontaneous pubertal development and regular menstrual cycles; the remaining 20 (86.9%) presented with primary amenorrhea.The median level of inhibin B in the TS patients with primary amenorrhea was 42 pg/mL and did not differ significantly among the different subgroups in relation to karyotype. The median inhibin B level in the control group was significantly higher than in the TS girls with primary amenorrhea (83 vs. 42 pg/mL, p<0.00001). In the three patients with TS and spontaneous menstrual cycles, the inhibin B levels were significantly higher when compared to the values of the TS girls with primary amenorrhea.TS patients with primary amenorrhea have significantly lower levels of inhibin B than TS girls with spontaneous puberty and healthy controls. Inhibin B does not correlate with follicle-stimulating hormone/luteinizing hormone. If our results are confirmed in further studies, inhibin B could become a first-line screening test for assessing ovarian reserve and a longitudinal marker of the possible decline of ovarian function in TS.


2015 ◽  
Vol 79 (2) ◽  
pp. 78-82 ◽  
Author(s):  
Huseyin Aksoy ◽  
Levent Cinar ◽  
Gokhan Acmaz ◽  
Ulku Aksoy ◽  
Turgut Aydin ◽  
...  

Author(s):  
Felipe Arturo Morales-Martínez ◽  
Celina Salas-Castro ◽  
Manuel Rolando. García-Garza ◽  
Otto Valdés-Martínez ◽  
Selene Marysol García-Luna ◽  
...  

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.


Author(s):  
Ewelina Czubacka ◽  
Bartosz Wielgomas ◽  
Anna Klimowska ◽  
Michał Radwan ◽  
Paweł Radwan ◽  
...  

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.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eun Young Park ◽  
Kyu-Hee Hwang ◽  
Ji-Hee Kim ◽  
San-Hui Lee ◽  
Kyu-Sang Park ◽  
...  

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.


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