Effect of Ovarian Torsion on Fertility

Ovarian Torsion on Fertility

Authors

  • Ahmed Mousa Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi

DOI:

https://doi.org/10.54393/pbmj.v5i9.802

Keywords:

Ovarian torsion, Infertility, Ovarian necrosis

Abstract

Ovarian torsion (OT) accounts for two to five percent of all gynecological emergencies. Clinical evidence indicates that 90% of patients who had surgical detorsion have functioning ovaries, however, there is a lack of information on the effect of OT on fertility in women who have been identified and treated for OT. Objectives: To tackle gaps in research on how fertility is affected in women who have had ovarian torsion surgery, based on imaging results, intraoperative findings, and operation type. Methods: A combination of retrospective and prospective studies was carried out on patients who were treated for ovarian torsion at Dr. Soliman Fakeeh Hospital in Jeddah, Saudi Arabia. The study was carried out through information collected from hospital records of patients who underwent ovarian torsion treatment during the period from January 2010 until March 2020. Patients who fulfilled the eligibility criteria were contacted by telephone, and information was collected regarding pregnancy (fertility). In this study, 20 patients who fulfilled the eligibility criteria were included in the analysis. Results: The follow-up data on the patient’s fertility showed that 14 (70%) women got pregnant and two patients who were already pregnant at the age of presentation of OT underwent term delivery. Conclusions: The study findings showed that ovarian torsion management irrespective of the type of treatment approach and procedure didn't significantly affect fertility, where 17 (85%) of patients showed a positive outcome on fertility. However, surgeons need to follow a more conservative approach by preserving both ovaries as much as possible.

References

Huchon C and Fauconnier A. Adnexal torsion: a literature review. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2010 May; 150(1):8-12.

Simsek E, Kilicdag E, Kalayci H, Yuksel Simsek S, Parlakgumus A. Repeated ovariopexy failure in recurrent adnexal torsion: combined approach and review of the literature. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2013 Oct; 170(2):305-8. doi: 10.1016/j.ejogrb.2013.06.044

Kelleher CM and Goldstein AM. Adnexal masses in children and adolescents. Clinical Obstetrics and Gynecology. 2015 Mar; 58(1):76-92. doi: 10.1097/GRF.0000000000000084

Stany MP and Hamilton CA. Benign disorders of the ovary. Obstetrics and Gynecology Clinics of North America. 2008 Jun; 35(2):271-84, ix. doi: 10.1016/j.ogc.2008.03.004

Heling KS, Chaoui R, Kirchmair F, Stadie S, Bollmann R. Fetal ovarian cysts: prenatal diagnosis, management and postnatal outcome. Ultrasound in Obstetrics and Gynecology. 2002 Jul; 20(1):47-50. doi: 10.1046/j.1469-0705.2002.00725.x

Holt VL, Cushing-Haugen KL, Daling JR. Oral contraceptives, tubal sterilization, and functional ovarian cyst risk. Obstetrics and Gynecology. 2003 Aug; 102(2):252-8. doi: 10.1016/s0029-7844(03)00572-6

American College of Obstetricians and Gynecologists. Practice bulletin no. 174: evaluation and management of adnexal masses. Obstetrics and gynecology. 2016 Nov; 128(5):e210-26.

Lass A. The fertility potential of women with a single ovary. Human Reproduction Update. 1999 Oct; 5(5):546-50. doi: 10.1093/humupd/5.5.546

Al-Turki HA. Prevalence of primary and secondary infertility from tertiary center in eastern Saudi Arabia. Middle East Fertility Society Journal. 2015 Dec; 20(4):237-40. doi: 10.1016/j.mefs.2015.02.001

Motlagh Asghari K, Nejadghaderi SA, Alizadeh M, Sanaie S, Sullman MJM, Kolahi AA, et al. Burden of polycystic ovary syndrome in the Middle East and North Africa region, 1990-2019. Scientific Reports. 2022 Apr; 12(1):7039. doi: 10.1038/s41598-022-11006-0

Centers for Disease Control and Prevention. Series 23, Number 25. Vital and Health Statistics. [Updated 2007; Accessed 2021]. Available from URL: http://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdf

Hartley J, Akhtar M, Edi-Osagie E. Oophoropexy for Recurrent Ovarian Torsion. Case Reports in Obstetrics and Gynecology. 2018 Feb; 2018:8784958. doi: 10.1155/2018/8784958

Peña JE, Ufberg D, Cooney N, Denis AL. Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Fertility and Sterility. 2000 May; 73(5):1047-50. doi: 10.1016/s0015-0282(00)00487-8

Schelling M. Adnextumoren in der Schwangerschaft. Geburtshilfe. Heidelberg, Springer. 2000.

Bider D, Mashiach S, Dulitzky M, Kokia E, Lipitz S, Ben-Rafael Z. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. Surgery, Gynecology and Obstetrics. 1991 Nov; 173(5):363-6

Gal D, Lind L, Lovecchio JL, Kohn N. Comparative study of laparoscopy vs. laparotomy for adnexal surgery: efficacy, safety, and cyst rupture. Journal of Gynecologic Surgery. 1995 Fall; 11(3):153-8. doi: 10.1089/gyn.1995.11.153

Pittaway DE, Takacs P, Bauguess P. Laparoscopic adnexectomy: a comparison with laparotomy. The American Journal of Obstetrics and Gynecology. 1994 Aug; 171(2):385-9. doi: 10.1016/s0002-9378(94)70039-7

Oelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Human Reproduction. 2003 Dec; 18(12):2599-602. doi: 10.1093/humrep/deg498

Tsafrir Z, Hasson J, Levin I, Solomon E, Lessing JB, Azem F. Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2012 Jun; 162(2):203-5. doi: 10.1016/j.ejogrb.2012.02.027

Galinier P, Carfagna L, Delsol M, Ballouhey Q, Lemasson F, Le Mandat A, et al. Ovarian torsion. Management and ovarian prognosis: a report of 45 cases. Journal of Pediatric Surgery. 2009 Sep; 44(9):1759-65. doi: 10.1016/j.jpedsurg.2008.11.058

Geimanaite L and Trainavicius K. Ovarian torsion in children: management and outcomes. Journal of Pediatric Surgery. 2013 Sep; 48(9):1946-53. doi: 10.1016/j.jpedsurg.2013.04.026

Parelkar SV, Mundada D, Sanghvi BV, Joshi PB, Oak SN, Kapadnis SP, et al. Should the ovary always be conserved in torsion? A tertiary care institute experience. Journal of Pediatric Surgery. 2014 Mar; 49(3):465-8. doi: 10.1016/j.jpedsurg.2013.11.055

Lo LM, Chang SD, Horng SG, Yang TY, Lee CL, Liang CC. Laparoscopy versus laparotomy for surgical intervention of ovarian torsion. Journal of Obstetrics and Gynaecology Research. 2008 Dec; 34(6):1020-5. doi: 10.1111/j.1447-0756.2008.00806.x

Tobiume T, Shiota M, Umemoto M, Kotani Y, Hoshiai H. Predictive factors for ovarian necrosis in torsion of ovarian tumor. The Tohoku Journal of Experimental Medicine. 2011 Nov; 225(3):211-4. doi: 10.1620/tjem.225.211

Djavadian D, Braendle W, Jaenicke F. Laparoscopic oophoropexy for the treatment of recurrent torsion of the adnexa in pregnancy: case report and review. Fertility and Sterility. 2004 Oct; 82(4):933-6. doi: 10.1016/j.fertnstert.2004.03.048

Varras M, Tsikini A, Polyzos D, Samara Ch, Hadjopoulos G, Akrivis Ch. Uterine adnexal torsion: pathologic and gray-scale ultrasonographic findings. Clinical and Experimental Obstetrics and Gynecology. 2004; 31(1):34-8

Cabry R, Merviel P, Hazout A, Belloc S, Dalleac A, Copin H, et al. Management of infertility in women over 40. Maturitas. 2014 May; 78(1):17-21. doi: 10.1016/j.maturitas.2014.02.014

Khan MS, Shaikh A, Ratnani R. Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer. The Journal of Obstetrics and Gynaecology of India. 2016 Oct; 66(Suppl 1):377-82. doi: 10.1007/s13224-015-0742-5

Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. Journal of Ultrasound in Medicine. 2011 Sep; 30(9):1205-10. doi: 10.7863/jum.2011.30.9.1205

Eskandar O, Eckford S, Watkinson T. Safety of diagnostic imaging in pregnancy. Part 2: magnetic resonance imaging, ultrasound scanning and Doppler assessment. The Obstetrician & Gynaecologist. 2010 Jul; 12(3):171-7.

Bai W, Xu X, Xie H, Sun C, Che K, Liu M, et al. Adnexal torsion in the third trimester of pregnancy: a case report and diagnostic value of MR imaging. BMC Medical Imaging. 2020 Feb; 20(1):19. doi: 10.1186/s12880-020-00422-1

Bellati F, Ruscito I, Gasparri ML, Antonilli M, Pernice M, Vallone C, et al. Effects of unilateral ovariectomy on female fertility outcome. Archives of Gynecology and Obstetrics. 2014 Aug; 290(2):349-53. doi: 10.1007/s00404-014-3194-8

Mohan M and Rajamahendran R. Effects of unilateral ovariectomy on follicular development and ovulation in cattle. Theriogenology. 1998 Apr; 49(5):1059-70. doi: 10.1016/s0093-691x(98)00054-5

Aydin Y, Celiloglu M, Koyuncuoglu M, Ulukus C. Follicular dynamics and apoptosis following unilateral oophorectomy. Systems Biology in Reproductive Medicines. 2010 Aug; 56(4):311-7. doi: 10.3109/19396368.2010.496033

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Published

2022-09-30
CITATION
DOI: 10.54393/pbmj.v5i9.802
Published: 2022-09-30

How to Cite

Mousa, A. . (2022). Effect of Ovarian Torsion on Fertility: Ovarian Torsion on Fertility. Pakistan BioMedical Journal, 5(9), 46–51. https://doi.org/10.54393/pbmj.v5i9.802

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