Brennand Erin A, Scime Natalie V, Manion Rebecca, Huang Beili
Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
BJOG. 2025 Feb;132(3):337-345. doi: 10.1111/1471-0528.17980. Epub 2024 Oct 10.
To determine the association between unilateral oophorectomy (UO) and age at natural menopause.
Secondary analysis of survey data from Alberta's Tomorrow Project (2000-2022).
Prospective cohort study in Alberta, Canada.
23 630 women; 548 experienced UO and 23 082 did not experience UO.
Flexible parametric survival analysis was used to analyse age at natural menopause, and logistic regression was used to analyse early menopause and premature ovarian insufficiency by UO status, controlling for birth year, parity, age at menarche, past infertility, hormonal contraceptive use and smoking.
Age at natural menopause occurred by a final menstrual period without medical cause and sub-classified as early menopause (< 45 years) and premature ovarian insufficiency (< 40 years).
Compared to no UO, any UO was associated with elevated risk of earlier age at natural menopause, which was strongest in early midlife (adjusted HR at age 40 1.71, 95% CI 1.31-2.19) and diminished over time. Compared to age 55 years at UO, risks of earlier age at natural menopause were largest and uniform in magnitude when UO occurred between approximately ages 20-40 years (adjusted HR for UO at age 30 2.32, 1.46-3.54) and then diminished as age at UO approached the average age at natural menopause. Any UO was associated with higher odds of early menopause (adjusted OR 1.90, 1.30-2.79) and premature ovarian insufficiency (adjusted OR 3.75, 1.72-8.16).
Unilateral oophorectomy is associated with earlier age at natural menopause, particularly when performed before 40 years of age.
确定单侧卵巢切除术（UO）与自然绝经年龄之间的关联。
对艾伯塔省明日项目（2000 - 2022年）的调查数据进行二次分析。
加拿大艾伯塔省的前瞻性队列研究。
23630名女性；548名经历了单侧卵巢切除术，23082名未经历单侧卵巢切除术。
采用灵活的参数生存分析来分析自然绝经年龄，并使用逻辑回归分析根据单侧卵巢切除术状态划分的早期绝经和卵巢早衰情况，同时控制出生年份、产次、初潮年龄、既往不孕史、激素避孕药使用情况和吸烟情况。
自然绝经年龄是指末次月经无医学原因出现的年龄，并细分为早期绝经（<45岁）和卵巢早衰（<40岁）。
与未进行单侧卵巢切除术相比，任何单侧卵巢切除术都与自然绝经年龄提前的风险升高相关，在中年早期最为明显（40岁时调整后的风险比为1.71，95%置信区间为1.31 - 2.19），且随着时间推移而降低。与单侧卵巢切除术时年龄为55岁相比，当单侧卵巢切除术发生在大约20 - 40岁之间时，自然绝经年龄提前的风险最大且幅度一致（30岁时单侧卵巢切除术的调整后风险比为2.32，1.46 - 3.54），然后随着单侧卵巢切除术时的年龄接近自然绝经的平均年龄而降低。任何单侧卵巢切除术都与早期绝经（调整后的比值比为1.90，1.30 - 2.79）和卵巢早衰（调整后的比值比为3.75，1.72 - 8.16）的较高几率相关。
单侧卵巢切除术与自然绝经年龄提前相关，尤其是在40岁之前进行手术时。
