An Evaluation of the Oxidative Stress Response of the Female Rabbit Reproductive Organs to Tourniquet-Induced Ischemia-Reperfusion Injury

Abstract Background: Ischemia-reperfusion injury (IRI) is likely to occur when tourniquets or clamps are applied to uterine blood vessels during uterine surgeries and may impair reproductive functions. However, the impact on reproductive functions is not fully understood. The aim of this study was to assess the impact of IRI on the female rabbit reproductive organs. Methods: 12 rabbits were divided into 6 groups with varying tourniquet application durations (0-240) minutes respectively. Midline incisions were made above the pubic area, uterine arteries were identified and occluded with silk suture. Groups 3 - 6 had bilateral uterine vessels occluded for 60 - 240 minutes, respectively. The uterus, ovaries as well as the fallopian tubes were removed after reperfusion for 2 hours and sent for biochemical analysis of oxidative stress and antioxidant markers. Results: IRI caused oxidative stress, decreasing superoxide dismutase (SOD) activity and increasing malondialdehyde (MDA) levels. Each organ exhibited unique responses, with the ovaries being most sensitive and the uterus being most resistant. The third hour post-ischemia appeared to be a critical time point for introducing antioxidant therapy. The ovary exhibited the highest antioxidant response with glutathione peaking at 3 hours (135.25 nmol/dl) and 103.9 nmol/dl at the 4th hours. Conclusion: IRI has significant implications for reproductive health, and targeted antioxidant interventions may help mitigate oxidative damage. The findings suggest that the third hour post-ischemia is a crucial time point for therapeutic intervention to minimize IRI-related damage in reproductive surgeries.