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OVARY FUNCTIONAL STATE IN FEMALE ADOLESCENTS WITH A HISTORY OF INTACT UTERINE APPENDAGES TORSION.

OBJECTIVE
The aim: To assess the functional state of gonads in female adolescents with a history of intact uterine appendages torsion (IUAT).


PATIENTS AND METHODS
Materials and methods: A total of 55 adolescent girls aged from 13 to 17 years were examined. 35 patients with a history of IUAT were divided into two groups: group 1 consisted of 21 patients with organ-preserving surgical treatment (detorsion) and group 2 of 14 patients with radical surgical treatment of IUAT. 20 healthy girls formed the control group. Assessment of the ovarian reserve was performed by the determination of serum anti-Müllerian hormone (AMH) level. Ultrasound scan was used to evaluate ovaries volume, number and diameter of antral follicles.


RESULTS
Results: The AMH level in control group (2.4 ± 0.29 ng/ml) has no statistically significantly differences compared with group 1 (2.2 ± 0.35 ng/ml, p = 0.12) and differed significantly compared with group 2 (0.96 ± 0.11 ng/ml, p < 0.05). No statistically significant differences in ovary volume were found between group 1 and control group (6.02 ± 0.21 cm3 and 6.14 ± 0.17 cm3, respectively, p = 0.125). The number and diameter of antral follicles in group 1 didn`t significantly differ from the control group (3.85 ± 0.35 and 4.00 ± 0.25, p = 0.116, 3.57 ± 0.42 mm and 3.70 ± 0.31 mm, p = 0.128, respectively).


CONCLUSION
Conclusions: The method of choice for IUAT treatment taking into account upcoming motherhood is laparoscopy with detorsion. Dynamic ultrasound results and determination of AMH level indicate the organ-preserving tactics for surgical treatment of IUAT.