Assessment of ovarian reserve using serum anti‐Müllerian hormone after ovarian torsion surgery

• Published in: Pediatrics international Vol. 61; no. 5; pp. 504 - 507
• Main Authors: Oskayli, Meltem Caglar, Gulcin, Neslihan, Ozatman, Erdem, Gercel, Gonca, Mutus, Murat, Aksu, Burhan, Durakbasa, Cigdem Ulukaya
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.05.2019
• Subjects: Adolescent; Age; Age Factors; Anti-Mullerian Hormone - blood; anti‐Müllerian hormone; Child; Children; detorsion; Doppler effect; Ethical standards; Female; Follicles; Follow-Up Studies; Granulosa cells; Humans; Organ Sparing Treatments; Ovarian Diseases - blood; Ovarian Diseases - diagnostic imaging; Ovarian Diseases - surgery; Ovarian Reserve; ovarian torsion; Ovariectomy; Ovaries; Pediatrics; Preservation; Surgery; Time Factors; Torsion Abnormality - blood; Torsion Abnormality - diagnostic imaging; Torsion Abnormality - surgery; Ultrasonography, Doppler; Ultrasound; Young Adult; detorsion; anti-Müllerian hormone; ovarian reserve; ovarian torsion; child
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.13818

Background The aim of this study was to determine ovarian reserve using serum anti‐Müllerian hormone (AMH) level in children who had undergone either ovarian‐preserving surgery or oophorectomy because of ovarian torsion. Methods Patients 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. Results A 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). Conclusions The 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.