Effect of detorsion alone and in combination with enoxaparin therapy on ovarian reserve and serum antimüllerian hormone levels in a rat ovarian torsion model

Abstract

Objective: To investigate the effect of enoxaparin on ovarian reserve and serum antimüllerian hormone (AMH) levels in a rat ovarian torsion model.

Design: Experimental study.

Setting: Experimental surgery laboratory in a training and research hospital.

Animal(s): Fourteen female Wistar Hannover rats.

Intervention(s): 1) Control group received no special treatment other than abdominal exposure; 2) detorsion-only group received bilateral adnexal torsion (3-hour ischemia), and then after 3-hour torsion period, detorsion (reperfusion) was performed; and 3) detorsion-enoxaparin group received 0.5 mg/kg enoxaparin subcutaneously 2 hours before the same surgery as the detorsion-only group and a second 0.5 mg/kg dose of enoxaparin 24 hours after the first surgeries. Apart from the surgeries, preoperative and postoperative 1-mL blood samples were drawn from the right jugular vein of each rat.

Main outcome measure(s): Preoperative and postoperative serum AMH levels, histopathologic damage scores, and follicle counts in the ovarian tissue of the rats.

Result(s): Vascular congestion and hemorrhage scores were higher in the detorsion-enoxaparin group than in the detorsion-only and control groups. The number of small antral follicles was smaller in the detorsion-only group than in the control group. The difference in the pre- and postoperative AMH levels was higher in the detorsion-only group than in the control and detorsion-enoxaparin groups.

Conclusion(s): The combination of enoxaparin therapy with conventional ovarian detorsion is more effective in protecting the ovarian reserve than detorsion alone.

Keywords: Antimüllerian hormone; enoxaparin; ischemia; ovarian follicle; ovary.

Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.