Ovarian function before and after salpingectomy in artificial reproductive technology patients.
ABSTRACT To determine the effect of the removal of the tube on ovarian function we studied 52 artificial reproduction technology cycles in 26 women before and after undergoing laparoscopic salpingectomy for ectopic pregnancy. Ovarian response was measured by the duration and quantity of human menopausal gonadotrophins used in the cycle, the pre-ovulatory concentrations of oestradiol, the number of oocytes retrieved, and the quality of the embryos. All parameters were compared between cycles carried out before and after salpingectomy as well as between affected and unaffected sides. Our findings show no significant difference in any of the parameters studied. We conclude that laparoscopic salpingectomy does not abate ovarian response in artificial reproduction technology cycles that follow the procedure.
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ABSTRACT: To assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation. A historical cohort study. Denmark. 170 000 randomly selected women born 1947-1963 (10 000/year) were followed from 1977 until the end of 2010. Effect of hysterectomy with retained fallopian tubes or sterilisation on the risk of salpingectomy. Both were modelled in a Cox proportional hazards model as time-dependent covariates, analysing time to first salpingectomy. End of follow-up period was 31 December 2010. Of 9591 hysterectomies, 6456 (67.3%) had both fallopian tubes retained. HRs for salpingectomy after hysterectomy with retained fallopian tubes and sterilisation were 2.13 (95% 1.88 to 2.42) and 2.42 (2.21 to 2.64), as compared with those for non-hysterectomised and non-sterilised women. Women undergoing hysterectomy with retained fallopian tubes or sterilisation have at least a doubled risk of subsequent salpingectomy. Removal of the fallopian tubes at hysterectomy should therefore be recommended.BMJ Open 01/2013; 3(6). · 1.58 Impact Factor
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ABSTRACT: Recently, the distal Fallopian tube has attracted considerable attention not only as site of origin for serous cancer in women with BRCA mutations, but also as the anatomical location where the majority of serous ovarian cancers apparently develop. Consequently, the Fallopian tube may be the unique location where early 'ovarian' cancers can be found--which would contradict the long-standing impression that the ovaries and the Fallopian tubes are always simultaneously involved. Based on the dismal prognosis associated with ovarian cancer and our inability to screen for early-stage disease, we discuss the rationale for introducing salpinges-hysterectomy as new clinical standard for women in need of hysterectomy and further weigh the arguments for and against bilateral salpingectomy as a sterilization method. There is no known physiological benefit of retaining the post-reproductive Fallopian tube during hysterectomy or sterilization, especially as this does not affect ovarian hormone production. On the other hand, the consequences associated with a surgical menopause provide a rationale for preserving the ovaries in premenopausal women. Prophylactic removal of the Fallopian tubes during hysterectomy or sterilization would rule out any subsequent tubal pathology, such as hydrosalpinx, which is observed in up to 30% of women after hysterectomy. Moreover, this intervention is likely to offer considerable protection against later tumour development, even if the ovaries are retained. Thus, we recommend that any hysterectomy should be combined with salpingectomy. In addition, women over 35 years of age could also be offered bilateral salpingectomy as means of sterilization.Human Reproduction 08/2011; 26(11):2918-24. · 4.67 Impact Factor
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ABSTRACT: To investigate the consequence of salpingectomy on ovarian reserve by measuring anti-Müllerian hormone (AMH) levels prior to in-vitro fertilization (IVF) treatment in salpingectomised compared with non-salpingectomised women with tubal-factor infertility, women with unexplained infertility and fertile control women, and to evaluate whether AMH levels could predict IVF outcome. Cross-sectional study extended from a previousl prospective study. Four university fertility clinics. Seventy-one women with infertility and 21 fertile controls. Blood sampling and IVF and embryo transfer in the following cycle. Serum AMH levels and oocytes retrieved. AMH levels were significantly lower in the salpingectomy infertility group (median 16.1, range 5.2-54 pmol/l) compared to the non-salpingectomy tubal-factor infertility group (median 23.4, range 3.5-50 pmol/l; p=0.04). In all groups, AMH levels correlated positively with the number of oocytes retrieved. AMH predicted poor response (≤5 oocytes) with a sensitivity and specificity of 90% and 70%, at a 19 pmol/l cut-off value. Serum AMH levels were lower in salpingectomised women compared to women with tubal-factor infertility and preserved Fallopian tubes, indicating that ovarian reserve might be affected by tubal surgery. Furthermore, serum AMH levels could predict a poor oocyte response (<5 oocytes) in the study group of infertile women. This article is protected by copyright. All rights reserved.Acta Obstetricia Et Gynecologica Scandinavica 08/2013; · 1.85 Impact Factor