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Effect of Hysterectomy With Ovarian Preservation on Ovarian Function
- Source :
- Obstetrics & Gynecology. 118:1271-1279
- Publication Year :
- 2011
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2011.
-
Abstract
- To prospectively estimate the risk for earlier ovarian failure among women undergoing hysterectomy with ovarian preservation, as compared with women of similar age without hysterectomy.A prospective cohort study was conducted among women aged 30 to 47 years undergoing hysterectomy without bilateral oophorectomy (n=406) and women with intact uteri (n=465). Blood samples and questionnaire data were obtained at baseline and annually for up to 5 years. Hazard ratios (HR) for ovarian failure, defined as follicle-stimulating hormone levels 40 international units/L or higher, were calculated using Cox proportional hazards models.Ovarian failure occurred among 60 of the women with hysterectomy and 46 of the women in the control group. Women undergoing hysterectomy were at nearly a twofold increased risk for ovarian failure as compared with women with intact uteri (HR 1.92, 95% confidence interval [CI] 1.29-2.86). The proportional hazards model further estimated that 14.8% of women with hysterectomies experienced ovarian failure after 4 years of follow-up compared with 8.0% of the women in the control group. Risk for ovarian failure was greater for women who had a unilateral oophorectomy along with their hysterectomy (HR 2.93, 95% CI 1.57-5.49), but also it was significantly increased for women who retained both ovaries (HR 1.74, 95% CI 1.14-2.65).Increased risk of earlier ovarian failure is a possible consequence of premenopausal hysterectomy. Although it is unresolved whether it is the surgery itself or the underlying condition leading to hysterectomy that is the cause of earlier ovarian failure, physicians and patients should take into account this possible sequela when considering options for treatment of benign conditions of the uterus.II.
- Subjects :
- Adult
endocrine system
medicine.medical_specialty
endocrine system diseases
medicine.medical_treatment
Primary ovarian insufficiency
Ovary
Primary Ovarian Insufficiency
Hysterectomy
Article
Follicle-stimulating hormone
Postoperative Complications
Ovarian function
North Carolina
medicine
Humans
Prospective Studies
Prospective cohort study
Proportional Hazards Models
Gynecology
business.industry
Proportional hazards model
Ovarian failure
Obstetrics and Gynecology
Middle Aged
female genital diseases and pregnancy complications
medicine.anatomical_structure
Premenopause
Female
Follicle Stimulating Hormone
business
Subjects
Details
- ISSN :
- 00297844
- Volume :
- 118
- Database :
- OpenAIRE
- Journal :
- Obstetrics & Gynecology
- Accession number :
- edsair.doi.dedup.....6ec1db94aeb63175932f9fd8091537f2