Assessment of ovarian function by clinical, hormonal and sonological parameters in post hysterectomy premenopausal women

Background: Hysterectomy with or without ovarian preservation is one of the common gynaecological major surgery performed worldwide. Ovarian function in future life therefore remains a contentious subject when ovaries are preserved. Assessment of ovarian function was done by clinical, hormonal and sonological parameters in post hysterectomy premenopausal women to assess, onset of menopausal symptoms, serum hormonal levels, and anatomical status.Methods: The study was a prospective observational study of 110 premenopausal patients of 30 to 50 years of age undergoing hysterectomy for benign uterine conditions carried out from September 2014 to August 2016. Patients were followed up after operation at 3 months, 6 months and 1 year. Serum LH, serum FSH, serum Estrogen, bilateral ovarian volume and bilateral ovarian Doppler study were done at baseline and each visit. Patients were interviewed at each visit for menopausal symptoms. Menopausal Rating scale (MRS) questionnaire was used as a basis for assessing menopausal symptoms.Results: Significant difference noted in all the parameters like serum FSH, right and left ovarian volume and right and left ovarian pulsatility index at period of one year compared to preoperative values. No significant difference seen for serum LH and serum estrogen at period of one year. At 1 year 34 patients (34%) developed menopausal symptoms.Conclusions: For all premenopausal patients who undergo hysterectomy for benign conditions of uterus with their ovaries preserved, proper follow up should be done after the surgery for assessing ovarian function at intervals