Abdominal Myomectomy and Ovarian Reserve in Women at Child Bearing Period
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- Category: Vol. 88, March 2020
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Abdominal Myomectomy and Ovarian Reserve in Women at Child Bearing Period, AHMED MAHMOUD FARAG
Abstract Background: Ovarian reserve is defined as the existent quantitative and qualitative follicular supply found in the ovaries which may turn into mature follicles and assigns a woman's reproductive potential. The commonly appointed tests of ovarian reserve can be divided into static markers (FSH, estradiol, inhibin-B and [AMH] Anti-Mullerian Hormone), dynamic markers (clomi-phene citrate, gonadotrophins and gonadotrophin releasing hormone [GnRh] analogue stimulation tests) and ultrasono-graphic markers (Antral Follicle Count [AFC], ovarian volume and ovarian blood flow). Leiomyomas are the most common genital tract tumors of benign nature and the most frequent benign uterine disorder in women of reproductive period. Aim of Study: The study evaluated the effect of open myomectomy on ovarian reserve. From all ovarian reserve parameters, we use AFC and AMH to determine this effect due to their high specificity and sensitivity. Material and Methods: The study included 90 women in childbearing period with age ranging from 18 to 40 years old with negative pregnancy test and without surgical history of ovarian operation. AFC is determined by counting the number of follicles measuring (2-8mm) by TVS on cycle day 2 before the operation. While AMH is measured using blood sample to be determined by ELISA technique. Myomectomy was done postmenstrual. The 2 parameters were measured again 6 months post-operative with the same method before the operation to evaluate them as markers of ovarian reserve. The data we obtained was summarized, presented in tables and charts and analyzed in detailed methods by computerized system. Results: Our results found that, there were no significant changes in values of AMH and AFC after the operation (p-value is 0.713 for AMH) (p-value is 0.252 for AFC). The correlation or relationship between values of AMH and AFC were studied. From recruited data and after detailed statistical analysis we found positive correlation between AMH and AFC before and after the operation. There was no significant effect of sites and types of myomas on ovarian reserve.
Conclusion: From the results we obtained, we found that there was no significant effect of open myomectomy on ovarian reserve parameters.