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The Biochemical and Histologic Effects of Adnexal Torsion and Early Surgical Intervention to Unwind Detorsion on Ovarian Reserve: An Experimental Study

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Abstract

Objective

The aim of the present study was to determine to what extent ovarian reserves are affected by ischemia–reperfusion injury, evaluating the number of growing follicles and the serum levels of the ovarian hormones.

Study Design

Thirty female fertile adult Wistar albino rats, weighing 200 to 220 g, were previously numbered to randomization, and then randomly divided into 3 equal groups (n = 10): sham, torsion, and detorsion groups. In torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group.

Results

The mean number of preantral and small antral follicles in detorsion group were lower than those of the sham group (P < .01). After torsion, anti-Müllerian hormone (AMH), estradiol, and inhibin B levels decreased significantly compared to the preoperative and postoperative periods (P = .003, P = .032, and P = .014, respectively). In detorsion group, only AMH levels were found to decrease significantly following the 3-hour ischemia and 3-hour reperfusion (P < .05).

Conclusion

After adnexal torsion, a significant decrease in ovarian reserve has been detected for the first time in this study. Additionally, the results of this study suggest that conservative surgery alone is insufficient to protect ovarian reserve.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, Dicle University, Diyarbakir, Turkey, 21280

    Ali Özler MD, Abdulkadir Turgut MD, Hatice Ender Soydinç MD, Muhammet Erdal Sak MD & Mehmet Sıddık Evsen MD

  2. Department of Pathology, School of Medicine, Dicle University, Diyarbakır, Turkey

    Ulas Alabalik MD

  3. Department of Medical Biochemistry, School of Medicine, Dicle University, Diyarbakır, Turkey

    Mustafa Kemal Basarali MD

  4. Department of Histology and Embryology, School of Medicine, Dicle University, Diyarbakır, Turkey

    Engin Deveci MD

Authors
  1. Ali Özler MD
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  2. Abdulkadir Turgut MD
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  3. Hatice Ender Soydinç MD
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  4. Muhammet Erdal Sak MD
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  5. Mehmet Sıddık Evsen MD
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  6. Ulas Alabalik MD
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  7. Mustafa Kemal Basarali MD
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  8. Engin Deveci MD
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Correspondence to Ali Özler MD.

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Özler, A., Turgut, A., Soydinç, H.E. et al. The Biochemical and Histologic Effects of Adnexal Torsion and Early Surgical Intervention to Unwind Detorsion on Ovarian Reserve: An Experimental Study. Reprod. Sci. 20, 1349–1355 (2013). https://doi.org/10.1177/1933719113485300

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