Ovary Sparing Hysterectomy Tied to Early Ovarian Failure
Risk of ovarian failure up in women undergoing hysterectomy without bilateral oophorectomy
THURSDAY, Nov. 17 (HealthDay News) -- Women undergoing hysterectomy without bilateral oophorectomy have an almost two-fold increased risk of developing early ovarian failure than women of a similar age with intact uteri, according to a study published online Nov. 7 in Obstetrics & Gynecology.
Patricia G. Moorman, Ph.D., from Duke University in Durham, N.C., and colleagues compared the risk for earlier ovarian failure between women (aged 30 to 47 years) undergoing hysterectomy without bilateral oophorectomy (406 participants) and similar age women who did not undergo hysterectomy (465 participants) as controls. Blood samples and questionnaire data were collected at baseline and annually up to five years. Cox proportional hazards models were used to calculate hazard ratios (HRs) for ovarian failure, defined as follicle-stimulating hormone levels of 40 international units/L or higher.
The investigators found that 60 women with hysterectomy and 46 controls had ovarian failure. Compared to controls, the risk of ovarian failure increased nearly two-fold in women undergoing hysterectomy (HR, 1.92). Ovarian failure after four years of follow-up was found in 14.8 and 8 percent of women with hysterectomies and the controls, respectively. Women who had unilateral oophorectomy and hysterectomy had a significantly elevated risk of ovarian failure (HR, 2.93), as did women who retained both ovaries (HR, 1.74).
"Women undergoing hysterectomy are at significantly increased risk for earlier ovarian failure as measured by serum follicular stimulating hormone levels," the authors write.