Does ovarian cystectomy pose a risk to ovarian reserve and fertility?

Key content The impact of benign ovarian cysts on a woman’s fertility is dependent on the nature, size, number, bilaterality and risk of recurrence of the cyst(s). Children and adolescents presenting with pathological ovarian cysts require a multidisciplinary team approach and, where possible, fertility sparing treatment should be offered. Laparoscopic detorsion has the potential to preserve ovarian reserve and should remain the optimal treatment for ovarian torsion in girls and premenopausal women. Surgery for bilateral endometriomas has been shown to increase the risk of developing premature ovarian insufficiency. It is important to consider performing ovarian reserve assessments before any ovarian surgery in women who have not completed their family. Learning objectives To understand what factors need to be considered before making a decision to perform an ovarian cystectomy. To be aware of different surgical techniques and their impact on fertility outcomes. To take anatomical considerations into account to minimise damage to healthy ovarian tissue. Ethical issues The UK’s National Health Service does not routinely fund oocyte freezing for benign conditions

Efficacy of combination therapy of inositols, antioxidants and vitamins in obese and non-obese women with polycystic ovary syndrome: an observational study

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of both developed and developing countries. It is associated with insulin resistance, hyperinsulinemia, hyperandrogenism, oxidative stress and various long-term complications. The present study was undertaken to evaluate the efficacy and safety of the supplementation (Trazer F ForteTM-CORONA Remedies Pvt. Ltd.) providing combination of insulin sensitising agents (myo-inositol, D-chiro-inositol and chromium picolinate), antioxidants (N-acetylcysteine and lycopene) and vitamins (vitamin D, biotin and folic acid) in women with PCOS. After 12 weeks of supplementation, a significant improvement was observed in menstrual cyclicity, acne and hirsutism in both obese and lean PCOS patients. A significant reduction was observed in body weight and BMI of obese subjects. However, both parameters remain unchanged in lean subjects. We suggest that combination therapy of insulin sensitising agents, antioxidants and vitamins may be a fruitful approach for the management of PCOS.Impact statement What is already known on this subject? Monotherapy of insulin sensitising agents, antioxidants and vitamins is beneficial in the treatment of PCOS. What do the results of this study add? Combined use of insulin sensitising agents (myo-inositol, D-chiro-inositol and chromium picolinate), antioxidants (N-acetylcysteine and lycopene), and vitamins (vitamin D, biotin and folic acid) is safe and effective in obese and non-obese women with PCOS. What are the implications of these findings for clinical practice and/or further research? Since PCOS is a multifactorial and a complex endocrine disorder, combination therapy can be used for the comprehensive management of PCOS