Short term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve a pilot randomized controlled trial

Capsule:
Salpingectomy at the time of hysterectomy with ovarian preservation does not have any short-term effects on ovarian reserve.

Authors:
Austin D. Findley, M.D., Matthew T. Siedhoff, M.D., M.S.C.R., Kumari A. Hobbs, M.D., John F. Steege, M.D., Christina A. McCall, M.D., Erin T. Carey, M.D., M.S.C.R., Anne Z. Steiner, M.D., M.P.H.

Volume 100, Issue 6, Pages 1704-1708, December 2013

Abstract:

Objective:
To examine the short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve when ovarian preservation is planned in view of determining the feasibility of conducting the study on a larger scale.

Design:
Pilot randomized controlled trial.

Setting:
Tertiary care, academic medical center.

Patient(s):
Thirty premenopausal women aged 18 to 45 years undergoing laparoscopic hysterectomy with ovarian preservation for benign indications from April 2012 to September 2012.

Intervention(s):
Bilateral salpingectomy (n = 15) versus no salpingectomy (n = 15) at the time of laparoscopic hysterectomy with ovarian preservation.

Main Outcome Measure(s):
Antimüllerian hormone (AMH) measured preoperatively, at 4 to 6 weeks postoperatively, and at 3 months postoperatively, with operative time and estimated blood loss abstracted from the medical records.

Result(s):
The mean AMH levels were not statistically significantly different at baseline (2.26 vs. 2.25 ng/ml), 4 to 6 weeks postoperatively (1.03 vs. 1.25 ng/ml), or 3 months postoperatively (1.86 vs. 1.82 ng/ml) among women with salpingectomy versus no salpingectomy, respectively. There was also no statistically significant temporal change in the mean AMH level from baseline to 3 months postoperatively (−0.07 vs. −0.08 ng/ml) between the two groups. No difference in operative time (116 vs. 115 minutes) or estimated blood loss (70 vs. 91 mL) was observed.

Conclusion(s):
Salpingectomy at the time of laparoscopic hysterectomy with ovarian preservation is a safe procedure that does not appear to have any short-term deleterious effects on ovarian reserve, as measured by AMH level. Conducting a trial of this nature that is adequately powered with long-term follow-up evaluation would be feasible and is required to definitively confirm these results.

Clinical Trial Registration Number:
ClinicalTrials.gov, NCT01578759.

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