scholarly journals The Optimal Time of Ovarian Reserve Recovery After Laparoscopic Unilateral Ovarian Non-Endometriotic Cystectomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Huaping Li ◽  
Bin Yan ◽  
Yanli Wang ◽  
Zhiming Shu ◽  
Ping Li ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Resistance Index ◽  
Antral Follicle ◽  
Optimal Time ◽  
Time Interval ◽  
Treatment Protocols ◽  
Ovarian Cystectomy ◽  
Time Period ◽  
Referent Group ◽  
Rate Of Decline

BackgroundLaparoscopic ovarian cystectomy is established as the standard surgical approach for the treatment of benign ovarian cysts. However, previous studies have shown that potential fertility can be directly impaired by laparoscopic ovarian cystectomy, diminished ovarian reserve (DOR), and even premature ovarian failure. Therefore, fertility-preserving interventions are required for benign gynecologic diseases. However, there are still little data on the time period required for recovery of ovarian reserve after the laparoscopic unilateral ovarian cystectomy, which is very important for the individualization of treatment protocols. This study aimed at investigating the time needed for the ovarian reserve to recover after laparoscopic unilateral ovarian non-endometriotic cystectomy.Materials and MethodsSixty-seven patients with unilateral ovarian non-endometriotic cyst from Zhoupu and Punan Hospitals who underwent laparoscopic unilateral ovarian cystectomy were recruited as a postoperative observation group (POG). Also, 69 healthy age-matched women without ovarian cyst who did not undergo surgery were recruited as a referent group (RFG). Ovarian reserve with the serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E2) levels, ovarian arterial resistance index (OARI), and antral follicle counts (AFCs) were measured on the third to fifth days of the same menstrual cycle. A postoperative 6-month follow-up of cases was performed.ResultsCompared with RFG, AFC of cyst side in the POG group showed no difference in the first, third, and sixth postoperative month (F = 0.03, F = 0.02, F = 0.55, respectively; p = 0.873, p = 0.878, p = 0.460, respectively). The OARI of cyst side in the POG group revealed no differences in the first, third, and sixth postoperative month (F = 0.73, F = 3.57, F = 1.75, respectively; p = 0.395, p = 0.061, p = 0.701, respectively). In the first month, the postoperative AMH levels significantly declined, reaching 1.88 ng/ml [interquartile range (IQR): 1.61–2.16 ng/ml] in POG and 2.57 ng/ml (IQR: 2.32–2.83 ng/ml) in RFG (F = 13.43, p = 0.000). For the data of AMH levels stratified by age, the same trend was observed between less than 25 and more than 26 years old. At this same time interval, the postoperative rate of decline was significantly lower compared to the preoperative one in POG (32.75%). The same trend was observed between the POG and RFG groups (26.67%).ConclusionsThe optimal time for recovery of ovarian reserve after laparoscopic unilateral ovarian cystectomy is estimated to be 6 months.

scholarly journals The time-interval of ovarian reserve recovery after laparoscopic unilateral ovarian nonendometriotic cystectomy: a prospective cohort study

2019 ◽  
Author(s):  
huaping Li ◽  
bing Yan ◽  
yanli Wang ◽  
yahong Liu ◽  
zhou Liu
Keyword(s):  
Ovarian Reserve ◽  
Resistance Index ◽  
Reproductive Age ◽  
Optimal Time ◽  
Enzyme Linked Immunosorbent Assay ◽  
Time Interval ◽  
Ovarian Cystectomy ◽  
Referent Group ◽  
Rate Of Decline

Abstract Background: Ovarian benign cyst, frequently seen in women of reproductive age, is one of the most important causes of damaging effect of ovarian reserve. Laparoscopic ovarian cystectomy is established as the gold standard surgical approach to the ovarian benign cyst. Studies have shown that potential fertility can be directly impaired by laparoscopic ovarian cystectomy and diminished ovarian reserve. There is little data about the time-interval of ovarian reserve recovery after the laparoscopic unilateral ovarian cystectomy. The objective of this study was to investigate the time-interval of ovarian reserve recovery after laparoscopic unilateral ovarian nonendometriotic cystectomy.Method: In the first part of the study, a total number of 67 patients with unilateral ovarian nonendometriotic cyst who underwent laparoscopic unilateral ovarian cystectomy were recruited as a postoperative observation group (POG). A total number of 69 same-aged healthy women without ovarian cyst who did not undergo surgery were recruited as a referent group (RFG).The serum anti-Müllerian hormone (AMH) levels were measured using a commercially available enzyme-linked immunosorbent assay kit; the Follicle-stimulating hormone (FSH)and E2 levels, measured using a chemiluminescent reagent kit. The ovarian arterial resistance index (OARI) and AFC were measured by transvaginal ultrasonography on the 3rd-5th day of the same menstrual cycle. In the second part of the study, a prospective postoperative 6-month follow-up of cases was performed. Results: When compared with RFG, the AFC of POG’s cyst side showed no difference in the 1st, 3rd, 6th postoperative month (F = 0.03, 0.02, 0.55; P = 0.873, 0.878, 0.460). The OARI of POG’s cyst side presented no difference in the 1st, 3rd, 6th postoperative month ( F = 0.73, 3.57, 1.75; P=0.395, 0.061, 0.188). In the first month, the postoperative AMH levels declined significantly, 1.88 ng/ml (IQR: 1.61-2.16 ng/ml) in POG and 2.57 ng/ml (IQR: 2.32-2.83 ng/ml) in RFG (F = 13.43; P = 0.000). At the time interval, the rate of decline was significantly lower postoperatively than preoperatively in POG (32.75 %),and was also the case in the comparison of POG with RFG (26.67 %). Conclusions: After the laparoscopic unilateral ovarian cystectomy, the optimal time-interval can be the 6th month for ovarian reserve recovery. Semiannually, AMH levels were to be detected to find those whose window time to conceive was likely to be shorter than others of the same age.

scholarly journals Clinical Application of AMH Measurement in Assisted Reproduction

2020 ◽  
Vol 11 ◽  
Author(s):  
Hang Wun Raymond Li ◽  
Scott M. Nelson
Keyword(s):  
Decision Making ◽  
Ovarian Reserve ◽  
Clinical Decision Making ◽  
Prediction Models ◽  
Ovarian Response ◽  
Antral Follicle ◽  
Clinical Decision ◽  
Treatment Protocols ◽  
Treatment Pathways ◽  
Individualize Treatment

Anti-Müllerian hormone reflects the continuum of the functional ovarian reserve, and as such can predict ovarian response to gonadotropin stimulation and be used to individualize treatment pathways to improve efficacy and safety. However, consistent with other biomarkers and age-based prediction models it has limited ability to predict live birth and should not be used to refuse treatment, but rather to inform counselling and shared decision making. The use of absolute clinical thresholds to stratify patient phenotypes, assess discordance and individualize treatment protocols in non-validated algorithms combined with the lack of standardization of assays may result in inappropriate classification and sub-optimal clinical decision making. We propose that holistic baseline phenotyping, incorporating antral follicle count and other patient characteristics is critical. Treatment decisions driven by validated algorithms that use ovarian reserve biomarkers as continuous measures, reducing the risk of misclassification, are likely to improve overall outcomes for our patients.

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.

EFFECT OF LAPAROSCOPIC OVARIAN CYSTECTOMY FOR ENDOMETRIOMA ON OVARIAN RESERVE

2018 ◽  
Vol 24 (2) ◽  
pp. 150-156
Author(s):  
Azza Abd Elhameid ◽  
Abd Elaziz Amin ◽  
Amr Alnemr ◽  
Maha Selim Mohamed
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Cystectomy

Utilization of remote sensing for estimation of scale of cutting and growing of forest zones

2017 ◽  
Vol 920 (2) ◽  
pp. 57-60
Author(s):  
F.E. Guliyeva
Keyword(s):  
Remote Sensing ◽  
Fixed Time ◽  
Time Interval ◽  
Time Points ◽  
Average Value ◽  
Time Period ◽  
Remote Estimation ◽  
The Given ◽  
Forest Cutting

The study of results of relevant works on remote sensing of forests has shown that the known methods of remote estimation of forest cuts and growth don’t allow to calculate the objective average value of forests cut volume during the fixed time period. The existing mathematical estimates are not monotonous and make it possible to estimate primitively the scale of cutting by computing the ratio of data in two fixed time points. In the article the extreme properties of the considered estimates for deforestation and reforestation models are researched. The extreme features of integrated averaged values of given estimates upon limitations applied on variables, characterizing the deforestation and reforestation processes are studied. The integrated parameter, making it possible to calculate the averaged value of estimates of forest cutting, computed for all fixed time period with a fixed step is suggested. It is shown mathematically that the given estimate has a monotonous feature in regard of value of given time interval and make it possible to evaluate objectively the scales of forest cutting.

The impact of the workability of an automated technological system on the effective implementation of the production program when processing tools in glow discharge plasma generators

2021 ◽  
pp. 58-65
Author(s):  
V.A. Logvin ◽  
◽  
S.A. Sheptunov ◽  
Keyword(s):  
Glow Discharge ◽  
Discharge Plasma ◽  
Functional Dependence ◽  
Plasma Generator ◽  
Glow Discharge Plasma ◽  
Optimal Time ◽  
Time Interval ◽  
Production Program ◽  
The Impact ◽  
Plasma Generators

The conditions for the hardening of tools in accordance with the author’s technological routes in the optimal time interval are considered using the functional dependence of the serviceability of plasma generators. This dependence takes into account the workability of the technical devices involved in processing the laying batch of tools in the speci ed time interval. The probability of performing the production process in the estimated time is represented by the product of the trouble-free operation of each glow discharge plasma generator involved in the nishing processing of tools that require a different type of plasma exposure in a certain sequence and duration.

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