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Effects of uterine artery occlusion during myomectomy on ovarian reserve: Serial follow‐up of sex hormone levels, ultrasound parameters and Doppler characteristics
Author(s) -
Chen WenHsin,
Huang KuanHui,
Kung FuTsai
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14236
Subject(s) - medicine , ovarian reserve , antral follicle , uterine artery , blood flow , ovary , anti müllerian hormone , ovarian artery , ultrasound , hormone , gynecology , ovarian follicle , urology , pregnancy , radiology , infertility , genetics , gestation , biology
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.