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

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.