Unilateral oophorectomy and reproductive health
Abstract
Background: It is widely known that with increasing age fertility of women decreases. Contemporary understandings about oocyte pool and its impact on fertility led to introduction of the term ovarian reserve. Etiology of diminished ovarian reserve is multifactorial, widely influenced by genetic factors. In addition, there are further risk-factors (environmental, pathological, iatrogenic), which can directly or indirectly affect the physiologic process of ovarian aging.
Aim: The aim of this review was to discuss the diminished ovarian reserve, its etiology and statistics and to review unilateral oophorectomy as a significant risk factor for DOR. To evaluate the effects of this intervention on reproductive health with special focus on its influence on ovarian reserve.
Methods: Literature search was performed in following datebases: Pubmed, Medline, Cochrane Library, Web of Science using terms “unilateral oophorectomy” and “ovarian reserve”.
Results: Selected papers have been analyzed and after synthesis of evidence statistics and etiology of diminshed ovarian reserve are discussed in our article. Also statistics of unilater oophorectomy and its impact on ovarian reserve and reproductive aging are described in this review paper.
Conclusion: Age related changes have greater impact on ovarian response compared to only the nuber of remaining follicles. Some evidence about the impact of different factors in development of poor ovarian reserve is at some points controversial. Also the possible compensatory mechanisms after unilateral surgical interventions are not yet clear. Recent research about genetic factors and gene therapies are very promising. We consider that further research in this direction can improve the prognosis and success rates for different fertility treatments in women with diminished ovarian reserve.
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