Assessment of ovarian reserve using serum anti-Mullerian hormone after ovarian torsion surgery

Abstract

BackgroundThe aim of this study was to determine ovarian reserve using serum anti-Mullerian hormone (AMH) level in children who had undergone either ovarian-preserving surgery or oophorectomy because of ovarian torsion. MethodsPatients aged > 10 years who had undergone surgery for unilateral ovarian torsion were contacted for the study with ethics committee approval. Seventeen patients agreed to be included. ResultsA total of 10 patients had undergone ovarian detorsion and seven had undergone oophorectomy. Mean age at operation was 11.6 2.23 years (range, 8-15 years) and 13.2 +/- 2.17 years (range, 10-16 years), respectively (P = 0.46). Ovarian torsion was isolated in four patients in the first group, and in three in the second. The remainder had associated benign masses. At the time of this study, mean patient age was 18 +/- 2.11 years (range, 14-21 years) with a mean postoperative follow up of 5.9 +/- 2.8 years (range, 2-10.5 years). Echogenicity of all preserved ovaries was normal on pelvic Doppler ultrasonography, with presence of antral follicles in six. Three ovaries were smaller than expected for age, although two of these had antral follicles. Mean AMH was 5.54 +/- 2.25 ng/mL in the detorsion group and 2.70 +/- 2.11 ng/mL in the oophorectomy group (P = 0.04). ConclusionsThe presence of follicles in preserved ovaries after detorsion has been reported previously. AMH is expressed in granulosa cells of growing follicles and its serum level is valuable in assessing the quantitative aspects of ovarian reserve. Preservation of the ovary in children with torsion is justified in terms of future ovarian reserve.