Investigation of the Potential Treatment Effect of Botulinum Toxin Type A in Ovarian Torsion: Findings From the Rat Model.

[BACKGROUND] The aim of this study was to investigate the effects of botulinum toxin A on histological abnormalities, loss of ovarian reserve, and angiogenesis within the ovarian torsion-detorsion paradigm.

[METHODS] A total of 45 female Wistar albino rats were used for the study. The rats were randomly divided into five groups (n = 9 in each group): Control, Torsion, Torsion + Detorsion, Torsion + Detorsion + Botulinum toxin, and Botulinum toxin only. Follicular cell degeneration, vascular congestion, hemorrhage, inflammation, and vascular endothelial growth factor (VEGF) expression scores were compared histopathologically between the groups. Follicle numbers were compared. Anti-mullerian hormone levels were measured before and after torsion, detorsion, and treatments.

[RESULTS] Follicular cell degeneration, vascular congestion, hemorrhage, inflammation, and VEGF expression differed significantly between groups for each score (p < 0.001). The VEGF expression score was found to increase more in the torsion + detorsion + botulinum toxin group than in the torsion + detorsion group (2.67 ± 0.71 and 2.22 ± 0.67, respectively). There was a significant difference between the groups in secondary follicle counts (p = 0.04). The groups showed statistically significant differences in their anti-mullerian hormone levels (p < 0.001).

[CONCLUSION] This initial investigation of the effects of botulinum toxin on ovarian torsion (OT) has shown that botulinum toxin type A has the potential to be a useful adjunct treatment for fertility preservation. Our results proved the ovarian protective effect of botulinum toxin type A in rats with OT. Therefore, botulinum toxin type A may be a potential preventive agent against ovarian damage caused by torsion in the future.