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Vol. 18 No 3 | Spring 2016
Women's Health -> Journal Club
Journal Club: Ovarian-sparing hysterectomy and ovarian reserve
Dr Brett Daniels
FRANZCOG


This article is 4 years old and may no longer reflect current clinical practice.

Had time to read the latest journals? Catch up on some recent research by reading these mini-reviews by Dr Brett Daniels.

It is common to preserve the ovaries in premenopausal women having hysterectomy for benign conditions. Despite this, a number of previous studies have demonstrated that women who have received ovary-preserving hysterectomies have earlier menopause than women who have not had hysterectomy. Trabuco et al report the findings of prospective study of anti-Müllerian hormone (AMH), a marker of ovarian reserve levels, in 148 premenopausal women receiving ovary-sparing hysterectomy for benign conditions compared with a referent group of 72 women of the same age with intact reproductive organs. AMH levels were measured at baseline prior to surgery and one year later. The results showed that while there were no differences in AMH level between the two groups at baseline, women who received ovary-sparing hysterectomy had a significantly greater percentage decrease in AMH levels (40.7 per cent decrease compared with 20.9 per cent; P=001) and were more likely to have non-detectable levels (12.8 per cent compared with 4.7 per cent; P=5.02) at the one-year follow-up compared to the referent group. The authors hypothesise that the decrease in ovarian function following hysterectomy may be due to a disruption of ovarian blood flow due to hysterectomy, or a removal of endometrial endocrine or paracrine influences on the ovaries resulting in a loss of ovarian function.1

References

  1. Trabuco EC, Patricia G, Moorman PG, Algeciras-Schimnich A, et al. Association of ovary-sparing hysterectomy with ovarian reserve. Obstetrics & Gynecology. 2016;127,819-827.

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