Roberta Venturella1, Daniela Lico2, Massimo Borelli3, Maria G Imbrogno2, Gabriele Cevenini4, Errico Zupi5, Fulvio Zullo2, Michele Morelli2. 1. Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy. Electronic address: rovefa@libero.it. 2. Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy. 3. Department of Life Sciences, University of Trieste, Trieste, Italy. 4. Department of Medical Biotechnologies, University of Siena, Siena, Italy. 5. Department of Biomedicine and Prevention, Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata", Rome, Italy.
Abstract
STUDY OBJECTIVE: Preliminary data on the effects of prophylactic bilateral salpingectomy (PBS) show that postoperative ovarian function is preserved up to 3 months after surgery. The confirmation of PBS safety on ovarian function even many years after surgery is essential to reassure the medical community that this new strategy, recently proposed for the prevention of ovarian cancer, is at least able to avoid the risk of premature surgical menopause. We investigated whether the addition of PBS during total laparoscopic hysterectomy (TLH) causes long-term effects on ovarian function. DESIGN: An observational study (Canadian Task Force classification II-3). SETTING: Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy. PATIENTS: Seventy-nine patients who underwent TLH plus salpingectomy between September 2010 and September 2012 at our institution have been recalled to be submitted to ovarian reserve evaluation in February 2015. Eight of 79 women refused to participate in this follow-up study. INTERVENTIONS: The ovarian age of PBS patients has been determined through OvAge (OvAge sr., Catanzaro, Italy), a statistical model that combines antimüllerian hormone, follicle-stimulating hormone, 3-dimensional antral follicle count, vascular index, flow index, and vascular flow index values. The control group consisted of a large population of 652 healthy women (with intact uterus and adnexa) previously enrolled to build the OvAge model. Comparisons between ovarian ages of PBS patients and the control group have been assessed by analysis of covariance linear statistical modeling. MEASUREMENTS AND MAIN RESULTS: The main outcome measurement was the differences in the behavior within OvAge/age relation between PBS and control women. Descriptive statistics of those 71 enrolled PBS patients are the following: age, 49.61 ± 2.15 years; OvAge, 49.22 ± 2.57 years; follicle-stimulating hormone, 43.02 ± 19.92 mU/mL; antimüllerian hormone, 0.12 ± 0.20 ng/mL; 3-dimensional antral follicle count, 1.91 ± 1.28; vascular index, 2.80% ± 5.32%; flow index, 19.37 ± 5.88; and vascular flow index, 0.56 ± 1.12. Analysis of covariance disclosed that PBS and control women do not exhibit different behaviors (p = .900) within OvAge/age relation. CONCLUSION: According to our model, the addition of PBS to TLH in the late reproductive years does not modify the ovarian age of treated women up to 3 to 5 years after surgery.
STUDY OBJECTIVE: Preliminary data on the effects of prophylactic bilateral salpingectomy (PBS) show that postoperative ovarian function is preserved up to 3 months after surgery. The confirmation of PBS safety on ovarian function even many years after surgery is essential to reassure the medical community that this new strategy, recently proposed for the prevention of ovarian cancer, is at least able to avoid the risk of premature surgical menopause. We investigated whether the addition of PBS during total laparoscopic hysterectomy (TLH) causes long-term effects on ovarian function. DESIGN: An observational study (Canadian Task Force classification II-3). SETTING: Department of Obstetrics and Gynecology, "Magna Graecia" University, Catanzaro, Italy. PATIENTS: Seventy-nine patients who underwent TLH plus salpingectomy between September 2010 and September 2012 at our institution have been recalled to be submitted to ovarian reserve evaluation in February 2015. Eight of 79 women refused to participate in this follow-up study. INTERVENTIONS: The ovarian age of PBSpatients has been determined through OvAge (OvAge sr., Catanzaro, Italy), a statistical model that combines antimüllerian hormone, follicle-stimulating hormone, 3-dimensional antral follicle count, vascular index, flow index, and vascular flow index values. The control group consisted of a large population of 652 healthy women (with intact uterus and adnexa) previously enrolled to build the OvAge model. Comparisons between ovarian ages of PBSpatients and the control group have been assessed by analysis of covariance linear statistical modeling. MEASUREMENTS AND MAIN RESULTS: The main outcome measurement was the differences in the behavior within OvAge/age relation between PBS and control women. Descriptive statistics of those 71 enrolled PBSpatients are the following: age, 49.61 ± 2.15 years; OvAge, 49.22 ± 2.57 years; follicle-stimulating hormone, 43.02 ± 19.92 mU/mL; antimüllerian hormone, 0.12 ± 0.20 ng/mL; 3-dimensional antral follicle count, 1.91 ± 1.28; vascular index, 2.80% ± 5.32%; flow index, 19.37 ± 5.88; and vascular flow index, 0.56 ± 1.12. Analysis of covariance disclosed that PBS and control women do not exhibit different behaviors (p = .900) within OvAge/age relation. CONCLUSION: According to our model, the addition of PBS to TLH in the late reproductive years does not modify the ovarian age of treated women up to 3 to 5 years after surgery.
Authors: Akila Subramaniam; Christina T Blanchard; Britt K Erickson; Jeff Szychowski; Charles A Leath; Joseph R Biggio; Warner K Huh Journal: Obstet Gynecol Date: 2018-07 Impact factor: 7.661
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Authors: Miranda P Steenbeek; Laura A M van Lieshout; Johanna W M Aarts; Jurgen M J Piek; Sjors F P J Coppus; Leon F A G Massuger; Rosella P M G Hermens; Joanne A de Hullu Journal: J Gynecol Oncol Date: 2018-04-30 Impact factor: 4.401