title: Effect of hysterectomy with ovarian preservation on ovarian function.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  II.
authors: From the Cancer Prevention, Detection, and Control Research Program, Department of Community and Family Medicine, Duke University Medical Center, and the Departments of Obstetrics and Gynecology and Statistical Science, Duke University, Durham, North Carolina.
authors: Patricia G
authors: PG
authors: Moorman
authors: Evan R
authors: ER
authors: Myers
authors: Joellen M
authors: JM
authors: Schildkraut
authors: Edwin S
authors: ES
authors: Iversen
authors: Frances
authors: F
authors: Wang
authors: Nicolette
authors: N
authors: Warren
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D010053:Ovary / Q000502:physiology; D011183:Postoperative Complications / Q000453:epidemiology*; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D005640:Follicle Stimulating Hormone