Ovarian function after radical hysterectomy for carcinoma of the cervix

We present a prospective observational study of ovarian function following Wertheim's hysterectomy and its relationship to age at hysterectomy. Serum gonadotrophin measurements were made annually on 55 women following Wertheim's hysterectomy with ovarian preservation. Within 1 year of surgery four women (4/54) had biochemical evidence of ovarian failure, three of whom were over the age of 40 at operation. At 2 years eight women (8/51) had ovarian failure, seven of these women were over the age of 40 at the time of surgery. After 4 years 11 women had ovarian failure (11/34), eight of these were over the age of 40 at operation. Ovarian function following Wertheim's hysterectomy is well maintained in women under the age of 40 at the time of their surgery, 87% of these women had normal gonadotrophin levels 4 years after their surgery. For women over the age of 40 ovarian function is poorly maintained, with only 27% with normal gonadotrophins 4 years following surgery. These data suggest that we should carefully consider recommending bilateral oophorectomy at Wertheim's hysterectomy in women over the age of 40.