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Effect of Hysterectomy on Ovarian Reserve in the Early Postoperative Period Based on the Type of Surgery

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Objectives: This study aimed to evaluate the influence of simple hysterectomy on the ovarian reserve based on the type of surgery. Methods: Eighty-six premenopausal women between 31 and 48 years who underwent hysterectomy for benign gynecologic disease without additional adnexal surgery at a university hospital participated in this study. Seventy-one patients underwent laparoscopyassisted vaginal hysterectomy (LAVH), and 15 patients underwent abdominal hysterectomy (AH). Blood samples were obtained from all study participants on preoperative day and 3 days after the operation to determine the anti-Müllerian hormone (AMH) levels. Results: The postoperative reduction of the mean serum AMH level in the LAVH group (0.42 ± 0.76 ng/mL) was greater than that in the AH group, although the difference was not statistically significant (0.01 ± 0.60 ng/mL) (P = 0.053). The mean baseline AMH level (2.59 ± 2.33 ng/mL) was significantly reduced to 2.24 ± 2.08 ng/mL at 3 days after hysterectomy, and the mean rate of decline of AMH levels after surgery was 13.61% ± 30.81%. In subgroup analysis based on the type of surgery, the mean serum AMH level decreased significantly after surgery in the LAVH group, but no significant changes were found in serum AMH levels before and after the surgery in the AH group. Conclusions: These preliminary results suggest that simple hysterectomy affects the early postoperative decline of ovarian reserve, and these results might vary depending on the type of surgery.

Abstract

Objectives: This study aimed to evaluate the influence of simple hysterectomy on the ovarian reserve based on the type of surgery. Methods: Eighty-six premenopausal women between 31 and 48 years who underwent hysterectomy for benign gynecologic disease without additional adnexal surgery at a university hospital participated in this study. Seventy-one patients underwent laparoscopyassisted vaginal hysterectomy (LAVH), and 15 patients underwent abdominal hysterectomy (AH). Blood samples were obtained from all study participants on preoperative day and 3 days after the operation to determine the anti-Müllerian hormone (AMH) levels. Results: The postoperative reduction of the mean serum AMH level in the LAVH group (0.42 ± 0.76 ng/mL) was greater than that in the AH group, although the difference was not statistically significant (0.01 ± 0.60 ng/mL) (P = 0.053). The mean baseline AMH level (2.59 ± 2.33 ng/mL) was significantly reduced to 2.24 ± 2.08 ng/mL at 3 days after hysterectomy, and the mean rate of decline of AMH levels after surgery was 13.61% ± 30.81%. In subgroup analysis based on the type of surgery, the mean serum AMH level decreased significantly after surgery in the LAVH group, but no significant changes were found in serum AMH levels before and after the surgery in the AH group. Conclusions: These preliminary results suggest that simple hysterectomy affects the early postoperative decline of ovarian reserve, and these results might vary depending on the type of surgery.

참고문헌 (23)

  1. Aubuchon M, "Berek & Novak's gynecology", pp.1148~1150 (2012), Lippincott Williams & Wilkins
  2. Practice Committee of the American Society for Reproductive Medicine, "Aging and infertility in women", Fertil Steril, 86(5), pp.S248~S252 (2006)
  3. Iwase A, "Serum anti-Müllerian hormone level is a useful marker for evaluating the impact of laparoscopic cystectomy on ovarian reserve", Fertil Steril, 94, pp.2846~2849 (2010)
  4. Fritz MA, "Clinical gynecologic endocrinology and infertility", pp.1140~1153 (2011), Lippincott Williams & Wilkins
  5. van Rooij IA, "Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility : a longitudinal study", Fertil Steril, 83, pp.979~987 (2005)
  6. La Marca A, "Anti-Müllerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology", Hum Reprod, 22, pp.766~771 (2007)
  7. Falcone T, "Berek & Novak’s gynecology", pp.803~842 (2012), Lippincott Williams & Wilkins
  8. Siddle N, "The effect of hysterectomy on the age at ovarian failure : identification of a subgroup of women with premature loss of ovarian function and literature review", Fertil Steril, 47, pp.94~100 (1987)
  9. Moorman PG, "Effect of hysterectomy with ovarian preservation on ovarian function", Obstet Gynecol, 118, pp.1271~1279 (2011)
  10. EunHeeAhn, "Effect of Hysterectomy on Conserved Ovarian Function", Yonsei Medical Journal, 43(1), pp.53~58 (2002), 연세대학교의과대학
  11. Atabekoğlu C, "The effect of total abdominal hysterectomy on serum anti-Müllerian hormone levels : a pilot study", Climacteric, 15, pp.393~397 (2012)
  12. Lee DY, "Change in the ovarian environment after hysterectomy as assessed by ovarian arterial blood flow indices and serum anti-Müllerian hormone levels", Eur J Obstet Gynecol Reprod Biol, 151, pp.82~85 (2010)
  13. Wang HY, "Comparison of serum anti-Mullerian hormone levels following hysterectomy and myomectomy for benign gynaecological conditions", Eur J Obstet Gynecol Reprod Biol, 171, pp.368~371 (2013)
  14. Trabuco EC, "Association of ovary-sparing hysterectomy with ovarian reserve", Obstet Gynecol, 127, pp.819~827 (2016)
  15. Yuan H, "Comparing the effect of laparoscopic supracervical and total hysterectomy for uterine fibroids on ovarian reserve by assessing serum anti-mullerian hormone levels : a prospective cohort study", J Minim Invasive Gynecol, 22, pp.637~641 (2015)
  16. Abdelazim IA, "Ovarian function and ovarian blood supply following premenopausal abdominal hysterectomy", Prz Menopauzalny, 14, pp.238~242 (2015)
  17. Hehenkamp WJ, "Loss of ovarian reserve after uterine artery embolization : a randomized comparison with hysterectomy", Hum Reprod, 22, pp.1996~2005 (2007)
  18. Cho HY, "Assessment of ovarian reserve after hysterectomy: laparoscopic vs. non-laparoscopic surgery", Eur J Obstet Gynecol Reprod Biol, 210, pp.54~57 (2017)
  19. Song T, "Effect on ovarian reserve of hemostasis by bipolar coagulation versus suture during laparoendoscopic single-site cystectomy for ovarian endometriomas", J Minim Invasive Gynecol, 22, pp.415~420 (2015)
  20. Fedele L, "Bipolar electrocoagulation versus suture of solitary ovary after laparoscopic excision of ovarian endometriomas", J Am Assoc Gynecol Laparosc, 11, pp.344~347 (2004)
  21. Chun S, "Comparison of early postoperative decline of serum antiMüllerian hormone levels after unilateral laparoscopic ovarian cystectomy between patients categorized according to histologic diagnosis", Taiwan J Obstet Gynecol, 55, pp.641~645 (2016)
  22. Griesinger G, "Elimination half-life of anti-Müllerian hormone", J Clin Endocrinol Metab, 97, pp.2160~2163 (2012)
  23. Chang HJ, "Impact of laparoscopic cystectomy on ovarian reserve : serial changes of serum anti-Müllerian hormone levels", Fertil Steril, 94, pp.343~349 (2010)

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