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Background <p>Ovarian torsion is a gynecological emergency that compromises ovarian perfusion, leading to ischemia–reperfusion (IR) injury. Antioxidants such as vitamin C and anticoagulants like enoxaparin have been investigated for their potential to mitigate reperfusion-induced ovarian damage, particularly affecting both histological architecture and hormonal function. However, a comparative evaluation of their protective effects on both the torsioned (ipsilateral) and the unaffected (contralateral) ovary remains lacking.</p> Objective <p>This study aims to evaluate and compare the protective effects of vitamin C and enoxaparin on IR injury in both ipsilateral and contralateral ovaries, based on biochemical and histopathological outcomes.</p> Methods <p>Thirty-five adult female Wistar albino rats were randomly assigned to five groups. A standardized ovarian torsion-detorsion model was applied. Serum levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol were measured post-procedure. Histological assessment included evaluation of vascular (congestion, hemorrhage), inflammatory (leukocyte infiltration), and structural (follicular degeneration, interstitial edema) damage. Immunohistochemical analysis quantified tissue AMH expression via H-score.</p> Results <p>Vitamin C administration significantly reduced histopathological damage in the ipsilateral ovary and preserved AMH tissue levels. In contrast, enoxaparin did not demonstrate significant histological or biochemical protection. Vitamin C notably improved secondary follicle integrity, but did not influence primordial, primary, tertiary, or atretic follicle numbers, nor corpus luteum structure. No significant alterations were detected in the contralateral ovaries across all groups.</p> Conclusions <p>Vitamin C offers histopathological and hormonal protection against ovarian IR injury, unlike enoxaparin, which showed no measurable benefit. Importantly, ischemic damage to the torsioned ovary did not extend to the contralateral ovary. These findings support further evaluation of vitamin C as a therapeutic adjunct in ovarian torsion management.</p>

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Effects of Vitamin C and Enoxaparin on Ovarian Ischemia–Reperfusion Injury: A Histopathological and Hormonal Evaluation in a Rat Model

  • 期刊论文

  • 发表日期：

    2025年8月2日

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  • Ozlem Ulas,
  • Ismail Biyik,
  • Neziha Senem ARI,
  • Fikriye Yasemin Özatik,
  • Cenk Soysal,
  • Nadi Keskin,
  • Yasemin Tasci

摘要

Background

Ovarian torsion is a gynecological emergency that compromises ovarian perfusion, leading to ischemia–reperfusion (IR) injury. Antioxidants such as vitamin C and anticoagulants like enoxaparin have been investigated for their potential to mitigate reperfusion-induced ovarian damage, particularly affecting both histological architecture and hormonal function. However, a comparative evaluation of their protective effects on both the torsioned (ipsilateral) and the unaffected (contralateral) ovary remains lacking.

Objective

This study aims to evaluate and compare the protective effects of vitamin C and enoxaparin on IR injury in both ipsilateral and contralateral ovaries, based on biochemical and histopathological outcomes.

Methods

Thirty-five adult female Wistar albino rats were randomly assigned to five groups. A standardized ovarian torsion-detorsion model was applied. Serum levels of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol were measured post-procedure. Histological assessment included evaluation of vascular (congestion, hemorrhage), inflammatory (leukocyte infiltration), and structural (follicular degeneration, interstitial edema) damage. Immunohistochemical analysis quantified tissue AMH expression via H-score.

Results

Vitamin C administration significantly reduced histopathological damage in the ipsilateral ovary and preserved AMH tissue levels. In contrast, enoxaparin did not demonstrate significant histological or biochemical protection. Vitamin C notably improved secondary follicle integrity, but did not influence primordial, primary, tertiary, or atretic follicle numbers, nor corpus luteum structure. No significant alterations were detected in the contralateral ovaries across all groups.

Conclusions

Vitamin C offers histopathological and hormonal protection against ovarian IR injury, unlike enoxaparin, which showed no measurable benefit. Importantly, ischemic damage to the torsioned ovary did not extend to the contralateral ovary. These findings support further evaluation of vitamin C as a therapeutic adjunct in ovarian torsion management.