Hyperbaric oxygen and metformin treatment in ovarian torsion preserves ovarian reserve.

Objective: Ovarian torsion is a gynecological emergency that reduces ovarian reserve in reproductive-aged women. This study aimed to evaluate the effects of metformin and hyperbaric oxygen therapy (HBOT) on ovarian reserve after ovarian torsion.

Methods: Forty female Wistar-Albino rats were divided into five groups: control, torsion/detorsion (T), torsion/detorsion + metformin (TM), torsion/detorsion + HBOT (THBO), and torsion/detorsion + metformin + HBOT (TMHBO). Rats in the experimental groups underwent 2 h of unilateral ovarian torsion followed by detorsion. Metformin (50 mg/kg/day) and HBOT (100% oxygen at 2.4 atm for 2 h/day) were administered for 14 days post-detorsion. Serum AMH levels, tissue AMH expression, and ovarian follicle counts were evaluated.

Results: In the torsion group, ovarian histology was disrupted, follicle numbers decreased, TUNEL-positive cells increased, and both serum and tissue AMH levels were reduced. The TM, THBO, and TMHBO groups demonstrated improvements in follicle numbers, TUNEL-positive cells, and AMH levels compared to the torsion group. Among them, TMHBO exhibited the best numerical outcomes, but no significant superiority was observed among TM, THBO, and TMHBO groups.

Conclusions: Both metformin and HBOT were effective in preserving ovarian reserve following ovarian torsion. These therapies may have potential as protective treatments in gynecological emergencies involving ovarian torsion.