title: The biochemical and histologic effects of adnexal torsion and early surgical intervention to unwind detorsion on ovarian reserve: an experimental study.
abstract: OBJECTIVE
  The aim of the present study was to determine to what extent ovarian reserves are affected by ischemia-reperfusion injury, evaluating the number of growing follicles and the serum levels of the ovarian hormones.
  
  
  METHODS
  Thirty female fertile adult Wistar albino rats, weighing 200 to 220 g, were previously numbered to randomization, and then randomly divided into 3 equal groups (n = 10): sham, torsion, and detorsion groups. In torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group.
  
  
  RESULTS
  The mean number of preantral and small antral follicles in detorsion group were lower than those of the sham group (P < .01). After torsion, anti-Müllerian hormone (AMH), estradiol, and inhibin B levels decreased significantly compared to the preoperative and postoperative periods (P = .003, P = .032, and P = .014, respectively). In detorsion group, only AMH levels were found to decrease significantly following the 3-hour ischemia and 3-hour reperfusion (P < .05).
  
  
  CONCLUSIONS
  After adnexal torsion, a significant decrease in ovarian reserve has been detected for the first time in this study. Additionally, the results of this study suggest that conservative surgery alone is insufficient to protect ovarian reserve.
authors.affiliation: 1Department of Obstetrics and Gynecology, School of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ozler
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Turgut
authors.forename: Hatice Ender
authors.initials: HE
authors.lastname: Soydinç
authors.forename: Muhammet Erdal
authors.initials: ME
authors.lastname: Sak
authors.forename: Mehmet Siddik
authors.initials: MS
authors.lastname: Evsen
authors.forename: Ulas
authors.initials: U
authors.lastname: Alabalik
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Basarali
authors.forename: Engin
authors.initials: E
authors.lastname: Deveci
mesh_terms: D000290:Adnexa Uteri / Q000098:blood supply*; D000818:Animals; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004195:Disease Models, Animal; D004958:Estradiol / Q000097:blood; D005260:Female; D042341:Gonadal Hormones / Q000097:blood*; D007265:Inhibins / Q000097:blood; D010049:Ovarian Diseases / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006080:Ovarian Follicle / Q000473:pathology*; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D014102:Torsion Abnormality / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D015415:Biomarkers; D042341:Gonadal Hormones; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone
keywords: adnexal torsion; anti-Müllerian hormone; inhibin B; ovarian follicles; ovarian reserve