The biochemical and histologic effects of adnexal torsion and early surgical intervention to unwind detorsion on ovarian reserve: an experimental study

Reprod Sci. 2013 Nov;20(11):1349-55. doi: 10.1177/1933719113485300. Epub 2013 Apr 12.


Objective: The aim of the present study was to determine to what extent ovarian reserves are affected by ischemia-reperfusion injury, evaluating the number of growing follicles and the serum levels of the ovarian hormones.

Study design: Thirty female fertile adult Wistar albino rats, weighing 200 to 220 g, were previously numbered to randomization, and then randomly divided into 3 equal groups (n = 10): sham, torsion, and detorsion groups. In torsion and detorsion groups, bilateral adnexal torsion (3-hour ischemia) was carried out. Bilateral adnexal detorsion (3-hour reperfusion) was performed in the detorsion group.

Results: The mean number of preantral and small antral follicles in detorsion group were lower than those of the sham group (P < .01). After torsion, anti-Müllerian hormone (AMH), estradiol, and inhibin B levels decreased significantly compared to the preoperative and postoperative periods (P = .003, P = .032, and P = .014, respectively). In detorsion group, only AMH levels were found to decrease significantly following the 3-hour ischemia and 3-hour reperfusion (P < .05).

Conclusion: After adnexal torsion, a significant decrease in ovarian reserve has been detected for the first time in this study. Additionally, the results of this study suggest that conservative surgery alone is insufficient to protect ovarian reserve.

Keywords: adnexal torsion; anti-Müllerian hormone; inhibin B; ovarian follicles; ovarian reserve.

MeSH terms

  • Adnexa Uteri / blood supply*
  • Animals
  • Anti-Mullerian Hormone / blood
  • Biomarkers / blood
  • Disease Models, Animal
  • Estradiol / blood
  • Female
  • Gonadal Hormones / blood*
  • Inhibins / blood
  • Ovarian Diseases / blood
  • Ovarian Diseases / pathology
  • Ovarian Diseases / physiopathology
  • Ovarian Diseases / surgery*
  • Ovarian Follicle / pathology*
  • Rats
  • Rats, Wistar
  • Reperfusion Injury / blood
  • Reperfusion Injury / pathology
  • Reperfusion Injury / physiopathology
  • Reperfusion Injury / surgery*
  • Time Factors
  • Torsion Abnormality / blood
  • Torsion Abnormality / pathology
  • Torsion Abnormality / physiopathology
  • Torsion Abnormality / surgery*


  • Biomarkers
  • Gonadal Hormones
  • inhibin B
  • Estradiol
  • Inhibins
  • Anti-Mullerian Hormone