Ovarian reserve in patients with borderline ovarian tumors after surgical treatment

Abstract

Borderline ovarian tumors are often diagnosed in women under the age of 40 years (31.8 %), which determines the need to optimize the management of this cohort of patients, taking into account the possibility of maintaining their reproductive function. Purpose of the study. Assessment of the ovarian reserve based on a comprehensive sonographic diagnosis of the ovarian reserve in patients of reproductive age with borderline ovarian tumors. Materials and methods. Group I (n = 103) included patients with borderline serous epithelial ovarian tumors. Group II (n = 95) was formed from women with mucinous epithelial ovarian tumors. Comparison group III (n = 189) included patients with benign ovarian cystadenomas. Ultrasound scanning of the pelvic organs and color Doppler mapping (DLC) were performed using Aloka 3500, Semiens G‑60 ultrasound scanners operating in real time and equipped with a pulsed doppler using a 3.5 MHz convex sensor and a 7.5 MHz transvaginal sensor. Results. The number of antral follicles does not depend on the volume of the ovary. The healthy remaining ovarian tissue of the ovary is most pronounced in groups I and III, significantly less represented in group II (p ≤ 0.0001). Three months after adnexectomy, ovulatory function in the intact (healthy) ovary was preserved in 71% (n = 49) of women from group I; in 89% (n = 73) of patients of group II and in 93% (n = 25) of respondents of group III, with a predominance in group II (φ* = 2.7; p ≤ 0.0010 and φ* = 1.6; p ≤ 0.0500). After a conservative operation, the function of the operated (resected) ovary detected ovulation in 62% (n = 21) of group I participants; 68% (n = 9) of women of group II and 86% (n = 139) of patients of group III. After 6 months, an increase in the number of antral ovaries and the number of ovulations with a predominance of ovarian reserve in group III (p ≤ 0.0010 and p ≤ 0.0001) was generally observed. Conclusions. Integrated ultrasound is a reliable and objective method that evaluates the features of the ovulatory reserve in patients with borderline and benign ovarian tumors, which makes it possible to formulate a prognosis of a woman’s reproductive health after various types of surgical treatment.