Ovarian function after conservational ovarian surgery: a long-term follow-up study

To determine the long-term effects of conservational ovarian surgery on subsequent ovarian function.

Medical, surgical and menstrual records of 87 reproductive age women who have undergone pelvic surgery for indications including endometriosis, infertility, and pelvic pain between June 1982 and June 1989 were retrospectively reviewed.

Sixty-seven patients had ovarian surgery during their procedure; 26 ovarian cystectomies (OC), 19 partial ovarian resections (OR) and 22 ovariolyses (OL). Twenty patients had no ovarian surgery (NOS). The mean follow-up period was comparable in all groups (OL 32 +/- 15 months, OR 34 +/- 26 months, OC 41 +/- 30 months and NOS 37 +/- 21 months). The mean time to onset of the first postoperative menses was not significantly different among the four groups (OL 24 +/- 7 days, OR 24 +/- 13 days, OC 29 +/- 26 days and NOS 22 +/- 6 days). The cumulative conception rates were not significantly different (OL 23%, OR 37%, OC 19% and NOS 25%). Menstrual disturbances, defined as perceived deviations from preoperative patterns, did not appear to be related to the type or extent of ovarian surgery and occurred in comparable frequencies among patients with or without ovarian surgery (OL 23%, OR 37%, OC 23% and NOS 20%). In the majority of cases, menstrual disturbances occurred either in the early postoperative months and were self-limited, or much later in which case they were related to recurrent endometriosis. Premature ovarian failure has so far occurred in one patient suggesting an incidence comparable to that in the general population.

It is concluded that in this group of patients, conservational ovarian surgery had no significant effects on ovulatory and menstrual function over a prolonged follow-up period.