The role of therapeutic strategy in preventing ovarian reserve loss in women with benign unspecified ovarian tumors

Abstract

DOI: 10.52705/2788-6190-2025-01.2-04
УДК: 618.11-006.6-08:618.2-002.3

The objective: to analyze the results results of a prospective clinical study aimed at evaluating the impact of the morphological type of benign unspecified ovarian tumors (BUOTs) and the applied therapeutic strategy on ovarian reserve preservation and pregnancy rates in reproductiveaged women.
Materials and methods. The study included 120 patients, divided into three clinical groups with different management approaches: organ-preserving laparoscopic surgery with prophylactic support, standard surgery without additional therapy, and observation without surgical intervention. The following parameters were assessed: ovarian reserve markers (AMH, AFC), inflammatory
and angiogenic factors (IL-6, TNF-α, VEGF, HE-4), metabolic status (HOMA-IR), and pregnancy rates over an 18-month follow-up period.
Results. Detected that combining conservative surgery with comprehensive prophylactic therapy (antioxidants, progestins, metformin) reduced ovarian reserve loss to 6% (AMH), which was significantly lower than in the comparative (37%) and control (32%) groups. The pregnancy rate in the intervention group reached 70%, significantly higher than in the other groups (p < 0.01). Additionally, the study evaluated the efficacy of an alternative therapeutic approach involving ozone therapy and PRP (platelet-rich plasma) administration as part of postoperative rehabilitation. Ozone therapy significantly reduced IL-6 and TNF-α levels, while PRP demonstrated regenerative potential and improved follicular microenvironment stability. Patients receiving this support showed improved AFC dynamics and lower HE-4 levels (down to 45 pmol/L).
Conclusions. These findings are clinically significant and can serve as a foundation for personalized strategies in managing BUOTs, particularly in cases of concomitant endometriosis or reduced fertility potential.