The age of ovarian failure following premenopausal hysterectomy with ovarian conservation

Read, M. D.; Edey, Katharine; Hapeshi, Julie; Foy, Christopher

doi:10.1258/mi.2010.010022

Cited by 22 publications

(15 citation statements)

References 15 publications

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“…However, because these studies either had no control group (19) or compared women with hysterectomy to women with uterine artery embolization (21, 22), the results are not strictly comparable to our study.…”

Section: Discussioncontrasting

confidence: 81%

“…Other recent studies that have examined risk of ovarian failure after hysterectomy have been inconsistent in their conclusions, with two studies reporting no effect (19, 21) while another reported an adverse effect of hysterectomy on ovarian function (22). However, because these studies either had no control group (19) or compared women with hysterectomy to women with uterine artery embolization (21, 22), the results are not strictly comparable to our study.…”

Section: Discussionmentioning

confidence: 98%

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Effect of Hysterectomy With Ovarian Preservation on Ovarian Function

Moorman

Myers

Schildkraut

et al. 2011

Obstetrics &Amp; Gynecology

197

136

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Objective To prospectively estimate the risk for earlier ovarian failure among women undergoing hysterectomy with ovarian preservation, as compared to women of similar age without hysterectomy. Methods A prospective cohort study was conducted among women aged 30 to 47 years undergoing hysterectomy without bilateral oophorectomy (n=406) and women with intact uteri (n=465). Blood samples and questionnaire data were obtained at baseline and annually for up to 5 years. Hazard ratios (HR) for ovarian failure, defined as follicle-stimulating hormone (FSH) levels 40 IU/L or higher, were calculated using Cox proportional hazards models. Results Ovarian failure occurred among 60 of the women with hysterectomy and 46 of the control women. Women undergoing hysterectomy were at nearly a twofold increased risk for ovarian failure as compared to women with intact uteri (HR=1.92, 95% confidence interval (CI) 1.29 – 2.86). The proportional hazards model further estimated that 14.8% of women with hysterectomy experienced ovarian failure after four years of follow-up compared to 8.0% of the control women. Risk for ovarian failure was greater for women who had a unilateral oophorectomy along with their hysterectomy (HR=2.93, 95% CI 1.57 – 5.49), but also was significantly increased for women who retained both ovaries (HR=1.74, 95% CI 1.14 – 2.65). Conclusions Increased risk of earlier ovarian failure is a possible consequence of premenopausal hysterectomy. While it is unresolved whether it is the surgery itself or the underlying condition leading to hysterectomy that is the cause of earlier ovarian failure, physicians and patients should take into account this possible sequela when considering options for treatment of benign conditions of the uterus.

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Section: Discussioncontrasting

confidence: 81%

Section: Discussionmentioning

confidence: 98%

Effect of Hysterectomy With Ovarian Preservation on Ovarian Function

Moorman

Myers

Schildkraut

et al. 2011

Obstetrics &Amp; Gynecology

197

136

View full text Add to dashboard Cite

show abstract

“…Some evidence also suggests that women who undergo a USO have impaired ovarian function and earlier menopause following surgery [15][16][17][18] compared with women who maintain both ovaries. Thus, women surveyed remote from fertility-sparing USO may be menopausal and would have similar levels of sexual satisfaction as women who underwent a full BSO.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Sexual satisfaction and quality of life in survivors of localized cervical and ovarian cancers following fertility-sparing surgery

Chan

Letourneau

Salem

et al. 2015

Gynecologic Oncology

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“…Surgeries, especially those in pelvic region, such as hysterectomy [96], may also cause POI by affecting blood supply to ovaries or causing local inflammation [97]. Laparoscopic ovarian drilling (LOD) in women with PCOS does not necessarily end in diminished ovarian reserve or POI according to existing literature [98].…”

Section: Iatrogenic Causesmentioning

confidence: 99%

An update on primary ovarian insufficiency

Jin

Huang

2012

Sci. China Life Sci.

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Primary ovarian insufficiency (POI) occurs in about 1% of female population under the age of 40, leading to reproductive problems, an earlier encounter with menopausal symptoms, and complicated diseases. There are three presumable mechanisms involved in the development of POI, namely apoptosis acceleration, follicular maturation blocking and premature follicle activation, through the following studied causes: (i) chromosomal abnormalities or gene mutations: mostly involve X chromosome, such as FMR1 premutation; more and more potentially causal genes have been screened recently; (ii) metabolic disorders such as classic galactosaemia and 17-OH deficiency; (iii) autoimmune mediated ovarian damage: observed alone or with some certain autoimmune disorders and syndromes; but the specificity and sensitivity of antibodies towards ovary are still questionable; (iv) iatrogenic: radiotherapy or chemotherapy used in cancer treatment, as well as pelvic surgery with potential threat to ovaries' blood supply can directly damage ovarian function; (v) virus infection such as HIV and mumps; (vi) toxins and other environmental/lifestyle factors: cigarette smoking, toxins (e.g., 4-vinylcyclohexene diepoxide), and other environmental factors are associated with the development of POI. The etiology of a majority of POI cases is not identified, and is believed to be multifactorial. Strategies to POI include hormone replacement and infertility treatment. Assisted conception with donated oocytes has been proven to achieve pregnancy in POI women. Embryo cryopreservation, ovarian tissue cryopreservation and oocyte cryopreservation have been used to preserve ovarian reserve in women undergoing cancer treatments. Primary ovarian insufficiency (POI), commonly referred to as premature ovarian failure (POF), is defined as the occurrence of amenorrhea (for 4 months or more) before the age of 40 in women, accompanied with an increase of serum FSH to menopausal level (usually over 40 IU L 1 , obtained at least 1 month apart), and estradiol levels less than 50 pg mL 1 (which indicate hypoestrogenism) [1]. Primary ovarian insufficiency is first brought to light by Fuller Albright in 1942, who emphasized that the end stage of ovarian function is the primary defect rather than abnormality in gonadotropin secretion [2], and avoided the discomforting and inaccurate stressing on "failure", like death-sentence for ovarian function and conception.Menopause is a destined phase of women, which is expected to occur at around the age of (50±4) years in US women [3]. The age of 40 is two standard deviations below this average [4]. With an incidence of 1% in women under the age of 40, and 0.1% in women under the age of 30 [5], POI renders patients estrogen deficiency and anovulation, resulting in vasomotor symptoms (hot flashes and night sweats), atrophic vaginitis, dyspareunia, primary or secondary amenorrhea, and infertility. 76% of POI cases developed after normal puberty and establishment of regular menses [6]. Some of such conditions occur after stopping...

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The age of ovarian failure following premenopausal hysterectomy with ovarian conservation

Cited by 22 publications

References 15 publications

Effect of Hysterectomy With Ovarian Preservation on Ovarian Function

Effect of Hysterectomy With Ovarian Preservation on Ovarian Function

Sexual satisfaction and quality of life in survivors of localized cervical and ovarian cancers following fertility-sparing surgery

An update on primary ovarian insufficiency

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