Ovarian Conservation at Hysterectomy: Are We Making Progress?

Andrew M. Kaunitz, MD

More education is needed about the benefits of retaining the ovaries in women at average risk for ovarian cancer. 

In 2008, the American College of Obstetricians and Gynecologists issued guidance discouraging routine oophorectomy at the time of hysterectomy for benign disease in premenopausal women (Obstet Gynecol 2008; 111:231). In 2012, investigators surveyed 1002 randomly selected obstetrician-gynecologists (response rate, 44%) about their views and practices regarding elective bilateral oophorectomy (BO) at hysterectomy.

Proportions of respondents who indicated that elective BO was appropriate for women at average risk for ovarian cancer varied with the women's age (63% for women aged 51–65, 32% for women younger than 51, and 4% for women aged 41–45). Recommendations did not vary by respondents' age, sex, geographic region, or number of hysterectomies performed. Most respondents would proceed with BO for women with personal histories of breast cancer or family histories of ovarian cancer. Two thirds of respondents indicated they would perform BO if an average-risk woman aged 30 to 35 demanded this procedure.

Citation(s):

Harmanli O et al. Obstetrician-gynecologists' opinions on elective bilateral oophorectomy at the time of hysterectomy in the United States: A nationwide survey. Menopause 2014 Apr; 21:355.

Parker W.Oophorectomy versus salpingectomy: A convergence of ideas. Menopause 2014 Apr; 21:323.