Assessment of ovarian reserve using serum anti‐Müllerian hormone after ovarian torsion surgery

Abstract

Background The aim of this study was to determine ovarian reserve using serum anti‐Müllerian hormone (AMH) level in children who had undergone either ovarian‐preserving surgery or oophorectomy because of ovarian torsion. Methods Patients aged > 10 years who had undergone surgery for unilateral ovarian torsion were contacted for the study with ethics committee approval. Seventeen patients agreed to be included. Results A total of 10 patients had undergone ovarian detorsion and seven had undergone oophorectomy. Mean age at operation was 11.6 ± 2.23 years (range, 8–15 years) and 13.2 ± 2.17 years (range, 10–16 years), respectively (P = 0.46). Ovarian torsion was isolated in four patients in the first group, and in three in the second. The remainder had associated benign masses. At the time of this study, mean patient age was 18 ± 2.11 years (range, 14–21 years) with a mean postoperative follow up of 5.9 ± 2.8 years (range, 2–10.5 years). Echogenicity of all preserved ovaries was normal on pelvic Doppler ultrasonography, with presence of antral follicles in six. Three ovaries were smaller than expected for age, although two of these had antral follicles. Mean AMH was 5.54 ± 2.25 ng/mL in the detorsion group and 2.70 ± 2.11 ng/mL in the oophorectomy group (P = 0.04). Conclusions The presence of follicles in preserved ovaries after detorsion has been reported previously. AMH is expressed in granulosa cells of growing follicles and its serum level is valuable in assessing the quantitative aspects of ovarian reserve. Preservation of the ovary in children with torsion is justified in terms of future ovarian reserve.

Connective tissue dysplasia as a risk factor for adnexal torsion in adolescent girls

“…Також активно обговорюється роль фіксації придатків матки після їхньої деторсії, що особливо актуально для пацієнток з ДСТ. Ставлення до оваріопексії неоднозначне: кількість прихильників даного методу зростає, супротивники вважають, що неправильно виконана маніпуляція потенційно небезпечна в плані зниження фертильності (Oskayli et al, 2019). Очевидно, що оваріопексія повинна бути рекомендована при діагностованій ДСТ, відсутності органічної причини ППМ, при його рецидиві та видаленому контрлатеральному яєчнику.…”

Surgically treated ovarian lesions in preadolescent girls

“…Conservative surgical treatment of ovarian torsion by detorsion and of benign neoplasms by ovary-sparing techniques has been advocated instead of oophorectomy [14][15][16] to save viable ovarian tissue to preserve fertility and to avoid early menopause. 17,18 Purely cystic lesions with negative tumor markers or of small size have been suggested as indications for gonad sparing procedure. 19 In our data, ovarysparing procedures were rarely performed (21%) in 1-11-year old girls.…”

Peer Review #2 of "The relationship between anti-Müllerian hormone (AMH) levels and pregnancy outcomes in patients undergoing assisted reproductive techniques (ART) (v0.3)"

“…With increasing female age, fecundity in natural and stimulated ovarian cycles declines, as observed in population-based studies (Grynnerup et al, 2012) as well as in IVF studies (Scheffer et al, 2018). For this reason, there is a growing number of women of advanced age seeking treatment for infertility (Oskayli et al, 2019).…”