Korean J Obstet Gynecol.  2012 Jan;55(1):17-21. 10.5468/KJOG.2012.55.1.17.

Impact of hysterectomy on ovarian reserve in early postoperative period

• Chun S
• Jeon GH
• Cho HJ
• Ji YI

• KMID: 1836758
• DOI: http://doi.org/10.5468/KJOG.2012.55.1.17

Abstract

OBJECTIVE
The aim of this study was to evaluate the changes of the ovarian reserve in early postoperative period after hysterectomy in Korean women.
METHODS
We retrospectively reviewed the medical records and laboratory data of patients aged 30-50 years with regular menstruation before hysterectomy, and 31 patients were included in this study. All patients enrolled underwent scheduled hysterectomy with conservation of both ovaries (laparoscopy-assisted vaginal hysterectomy, n = 21; and total abdominal hysterectomy, n = 10), and received serum anti-Mullerian hormone (AMH) tests preoperatively and 3 days after operation. Changes between preoperative and postoperative AMH levels of each patient were calculated.
RESULTS
There were no significant differences between pre- and postoperative AMH concentration (2.46 +/- 0.49 ng/mL and 2.29 +/- 0.43 ng/mL; P = 0.200). No significant percentage reduction of AMH level existed (1.17 +/- 6.63%, P = 0.861).
CONCLUSION
Our results suggest that hysterectomy does not influence the ovarian reserve in early postoperative period.

Keyword

Ovarian reserve; Hysterectomy; Anti-Mullerian hormone

MeSH Terms

Aged
Anti-Mullerian Hormone
Female
Humans
Hysterectomy
Hysterectomy, Vaginal
Medical Records
Menstruation
Ovary
Postoperative Period
Retrospective Studies
Anti-Mullerian Hormone

Reference

1. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. 2011. 8th ed. Philadelphia (PA): Lippincott Williams & Wilkins.

2. Korean Society of Obstetrics and Gynecology. Gynecology. 2007. 4th ed. Seoul: Korean Medical Book Publisher.

3. Burney RO, Schust DJ, Yao MW. Berek JS, Novak E, editors. Infertility. Berek & Novak's gynecology. 2007. 14th ed. Philadelphia (PA): Lippincott Williams & Wilkins;1203–1204.

4. de Vet A, Laven JS, de Jong FH, Themmen AP, Fauser BC. Antimullerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril. 2002. 77:357–362.

5. Visser JA, de Jong FH, Laven JS, Themmen AP. Anti-Mullerian hormone: a new marker for ovarian function. Reproduction. 2006. 131:1–9.

6. La Marca A, Giulini S, Tirelli A, Bertucci E, Marsella T, Xella S, et al. Anti-Mullerian hormone measurement on any day of the menstrual cycle strongly predicts ovarian response in assisted reproductive technology. Hum Reprod. 2007. 22:766–771.

7. van Rooij IA, Broekmans FJ, Scheffer GJ, Looman CW, Habbema JD, de Jong FH, et al. Serum antimullerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: a longitudinal study. Fertil Steril. 2005. 83:979–987.

8. Lee JR, Kim SH. Anti-Mullerian hormone and female reproduction. Korean J Obstet Gynecol. 2009. 52:285–300.

9. Wu JM, Wechter ME, Geller EJ, Nguyen TV, Visco AG. Hysterectomy rates in the United States, 2003. Obstet Gynecol. 2007. 110:1091–1095.

10. Colditz GA, Willett WC, Stampfer MJ, Rosner B, Speizer FE, Hennekens CH. Menopause and the risk of coronary heart disease in women. N Engl J Med. 1987. 316:1105–1110.

11. Chalmers C. Does hysterectomy in a premenopausal woman affect ovarian function? Med Hypotheses. 1996. 46:573–575.

12. Janson PO, Jansson I. The acute effect of hysterectomy on ovarian blood flow. Am J Obstet Gynecol. 1977. 127:349–352.

13. Qu X, Cheng Z, Yang W, Xu L, Dai H, Hu L. Controlled clinical trial assessing the effect of laparoscopic uterine arterial occlusion on ovarian reserve. J Minim Invasive Gynecol. 2010. 17:47–52.

14. Hehenkamp WJ, Volkers NA, Broekmans FJ, de Jong FH, Themmen AP, Birnie E, et al. Loss of ovarian reserve after uterine artery embolization: a randomized comparison with hysterectomy. Hum Reprod. 2007. 22:1996–2005.

15. Cooper GS, Thorp JM Jr. FSH levels in relation to hysterectomy and to unilateral oophorectomy. Obstet Gynecol. 1999. 94:969–972.

16. Siddle N, Sarrel P, Whitehead M. 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. 1987. 47:94–100.

17. Derksen JG, Brölmann HA, Wiegerinck MA, Vader HL, Heintz AP. The effect of hysterectomy and endometrial ablation on follicle stimulating hormone (FSH) levels up to 1 year after surgery. Maturitas. 1998. 29:133–138.

18. Atay V, Ceyhan T, Baser I, Gungor S, Goktolga U, Muhcu M. Hysterectomy with preservation of both ovaries does not result in premature ovarian failure. J Int Med Res. 2007. 35:416–421.

19. Metcalf MG, Braiden V, Livesey JH. Retention of normal ovarian function after hysterectomy. J Endocrinol. 1992. 135:597–602.

20. Doğan MM, Başaran Z, Ekici E, Başaran O, Ozcan T, Gökay Z, et al. Effect of hysterectomy on ovarian blood supply and function. J Obstet Gynaecol. 1998. 18:263–266.

21. Lee DY, Park HJ, Kim BG, Bae DS, Yoon BK, Choi D. Change in the ovarian environment after hysterectomy as assessed by ovarian arterial blood flow indices and serum anti-Mullerian hormone levels. Eur J Obstet Gynecol Reprod Biol. 2010. 151:82–85.

22. Chan CC, Ng EH, Ho PC. Ovarian changes after abdominal hysterectomy for benign conditions. J Soc Gynecol Investig. 2005. 12:54–57.

23. Xiangying H, Lili H, Yifu S. The effect of hysterectomy on ovarian blood supply and endocrine function. Climacteric. 2006. 9:283–289.

24. Petri Nahás EA, Pontes A, Nahas-Neto J, Borges VT, Dias R, Traiman P. Effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age. J Ultrasound Med. 2005. 24:169–174.

25. Chalmers C, Lindsay M, Usher D, Warner P, Evans D, Ferguson M. Hysterectomy and ovarian function: levels of follicle stimulating hormone and incidence of menopausal symptoms are not affected by hysterectomy in women under age 45 years. Climacteric. 2002. 5:366–373.

26. Stadberg E, Mattsson LA, Milsom I. Factors associated with climacteric symptoms and the use of hormone replacement therapy. Acta Obstet Gynecol Scand. 2000. 79:286–292.

27. Oldenhave A, Jaszmann LJ, Everaerd WT, Haspels AA. Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am J Obstet Gynecol. 1993. 168:765–771.

28. Hartmann BW, Kirchengast S, Albrecht A, Metka M, Huber JC. Hysterectomy increases the symptomatology of postmenopausal syndrome. Gynecol Endocrinol. 1995. 9:247–252.