OBJECTIVE
To study the reproductive function of women who underwent organ-preserving surgery on the ovaries for benign tumors.
MATERIAL AND METHODS
The study included 1195 patients aged 18 to 40 years, who underwent surgery for ovarian tumors in the gynecological and oncogynecological department of the Pletnev City Clinical Hospital. The patients were divided into three groups: group I included patients aged 18-26 (n=233), group II — patients aged 27-35 (n=539), group III — patients aged 36-40 (n=423). Of these, 56 patients (20-35 years old) with a reduced ovarian reserve after surgical interventions on the ovaries, IVF was performed at the Center for Reproduction and Genetics. The group with unilateral adnexectomy (adnexectomy), cystectomy or ovarian resection included 29 patients, and the group with bilateral ovarian intervention included 27 examined patients.
RESULTS
As a result of the surgical intervention, there was a decrease in the level of anti-Müllerian hormone (AMH). Depending on the histological type of the tumor, AMH decreased most significantly with endometriomas, especially more than 5 cm in diameter, with their bilateral location. Patients with follicular (4.72±3.84-1.76±2.91 ng/ml; p=0.039) and endometriomas (2.55±1.87-0.72±1.39 ng/ml; p=0.024) had a significant decrease in AMH levels 6 months after surgical treatment. Whereas dermoid cysts (3.75±3.18-3.18±3.06 ng/ml; p=0.282) and other ovarian tumors (including cystadenomas) (from 3.56±2.36 to 2.91±2.03 ng/ml; p=0.143) did not show a significant decrease in AMH indicators. The highest rates of spontaneous pregnancy were in group I within 1 year, pregnancy occurred in 30.9% of cases and ended in childbirth, regardless of the histological type of tumor (p=0.012). In group II, pregnancy occurred within 12-15 months, ending in childbirth in 22.4% of cases (p=0.023). There were no significant differences in the frequency of pregnancy and their outcomes in the group of patients who underwent IVF infertility treatment.
CONCLUSIONS
Determination of the level of AMH in the preoperative period, as well as within 1 year, is necessary for the timely treatment of the patient to a reproductive doctor for the realization of her reproductive function, including in case of delayed motherhood.
