Effects of uterine artery occlusion during myomectomy on ovarian reserve: Serial follow‐up of sex hormone levels, ultrasound parameters and Doppler characteristics

Abstract

Aim: To evaluate the influence of uterine artery occlusion at myomectomy (UAO + M) on ovarian reserve based on serum sex hormone levels, ultrasound and color Doppler examinations. Methods: In this cohort study, nine women with symptomatic uterine myomas underwent UAO + M were recruited. Each woman was assessed preoperatively and 3, 6 months postoperatively, through a serial of hormonal, ultrasound parameters and Doppler examination for ovarian stromal blood flow. The data were analyzed using generalized estimating equations.Results: There was no significant difference in serum anti-Müllerian hormone (AMH) or follicle-stimulating hormone (FSH) levels before and 3, 6 months after UAO + M. The ovarian volume, antral follicle count (AFC) and ovarian stromal blood flow had significant changes in the right ovary. Ovarian volume and AFC significantly reduced at 3 months and recovered at 6 months postoperatively (P = 0.046, P = 0.019, respectively). Peak systolic velocity and end diastolic velocity significantly decreased at 3 months and leveled off at 6 months (P < 0.001, P = 0.001, respectively). Resistance index significantly increased at 3 months and decreased at 6 months (P = 0.037). A similar trend in ultrasound and Doppler findings was observed in the left ovary, but no statistical significance was found. Conclusion: UAO + M had no detrimental effect on ovarian reserve 6 months postoperatively based on AMH and FSH levels. AFC, ovarian volume and stromal blood flow were transiently decreased in 3 months and recovered in 6 months.

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

“…Although the AMH level decreased between pre-surgery and second-day values, this was not statistically significant. Similar findings have been reported by Chen et al [18], Mehdizadehkash et al [14], Sander et al [16], and Farag et al [21]. It did, however, differ from the of Aharon et al [15], Brown et al [19], Migahed et al [20], and Wang et al [22],…”

“…Several studies using AMH found no significant effect on ovarian function after myomectomy when the uterine tourniquet was used; however, other studies revealed a transient or short-term change in ovarian function after myomectomy [16] [17] [18]. Concerns have been raised that the ischaemic reperfusion injury caused by the single tourniquet approach, which is commonly used to limit blood loss during abdominal myomectomy, may diminish or modify ovarian reserve, affecting conception.…”

Effect of Congrong Tusi Pill on Ovarian Artery Blood Flow and Sex Hormones in Adjuvant Treatment of Ovarian Function Decline

“…Angelica can nourish blood and promote blood circulation. Herba Taxilli can reinforce the liver and kidney and strengthen the bones and muscles (Abdelnaby et al, 2020;Chen et al, 2020). Clinical research experiments have shown (Liu et al, 2019) that excessive androgen in the ovaries will also inhibit follicular maturation, thereby blocking further follicular development, and hindering normal formation of highquality follicles.…”

Effect of radical trachelectomy on ovarian reserve: A single‐institute prospective study

“…[19][20][21] However, studies have reported no reduction in AMH levels following uterine artery occlusion or embolization. [22][23][24] These conflicting reports highlight the uncertainty surrounding the relationship between blood flow the uterus and ovarian reserve, marking it as an area for future investigation.…”