Ovarian function before and after salpingectomy in artificial technology patients

Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin 70300, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University.
Human Reproduction (Impact Factor: 4.57). 01/2000; 15(1):142-4. DOI: 10.1093/humrep/15.1.142
Source: PubMed


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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Available from: Peer Dar, Jan 21, 2015
    • "There are many theories postulated, but none actually proven. We mention them all in brief here as it is not possible to discuss all of them at length.[3467913–1531–33] "
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    ABSTRACT: The first IVF baby, Louise Brown, was born in a natural cycle IVF of a woman who had bilateral tubal block making IVF the only option for having a child. The last 3 decades has seen astounding progress in the field of ART. Today thanks to ART, tubal disease and tubal factor infertility is easily overcome. The accepted theory today is that the hydrosalpinx fluid plays a causative role in the reduced pregnancy rate with ART. It is well known that the success of ART for patients with tubal disease with hydrosalpinx is reduced by half compared with patients without hydrosalpinx. Ideal would be removal of a hydrosalpinx by laparoscopic salpingectomy to improve pregnancy rates. However in some cases this is not feasible due to dense pelvic adhesions making access difficult. In such cases it is recommended that even de-linking the tube from the uterus would help in improving the ART outcome. There is suggestion that sonographically visible hydrosalpinges and those affected bilaterally have a poorer prognosis than those seen incidentally at laparoscopy. While there is clinical evidence supporting the causative role of the fluid itself, there is a lack of knowledge as to how the fluid exerts its negative effects. It is generally believed that the fluid holds a key position in impairing implantation potential. The aim of this review is to highlight the importance of identifying hydrosalpinges and its association with reduced fertility outcome using assisted reproductive technologies. Here we have discussed the different options available for the same, and highlighted the current modes of treatment.
    Journal of Gynecological Endoscopy and Surgery 03/2009; 1(1):12-6. DOI:10.4103/0974-1216.51903
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    • "In two retrospective case-controlled studies (Verhulst et al., 1994; Tal et al., 2002), no difference in ovarian response after gonadotrophin stimulation during IVF treatment could be found between patients with and without salpingectomy. In order to limit bias introduced by the control group, Dar et al. (2000) and Strandell et al. (2001) used the patients themselves as the controls, and compared the ovarian response to gonadotrophin during IVF treatment before and after salpingectomy . There was again no difference demonstrated. "
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    ABSTRACT: Whether salpingectomy affects ovarian function is controversial. In this study, ovarian function was assessed by antral follicle count, ovarian volume and ovarian stromal blood flow measured by three-dimensional (3D) power Doppler ultrasonography. The objectives of the study were to compare the ovarian function of the operated side with the non-operated side after unilateral salpingectomy performed through laparoscopy or laparotomy for ectopic pregnancy. Thirty-two patients with unilateral salpingectomy performed for ectopic pregnancy were recruited: 18 through laparoscopy and 14 through laparotomy. Ultrasound scans were performed in the early follicular phase. Ovarian volume, antral follicle count and 3D power Doppler indices were comparable between the operated and the non-operated sides in the whole group and in the laparotomy group. The antral follicle count and 3D power Doppler indices were significantly reduced on the operated side in the laparoscopy group. Ovarian function seems to be impaired after laparoscopic unilateral salpingectomy at short-term assessment.
    Human Reproduction 11/2003; 18(10):2175-80. DOI:10.1093/humrep/deg411 · 4.57 Impact Factor
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    • "It has been reported that laparoscopic salpingectomy does not abate ovarian response during IVF treatment (Dar et al., 2000), but an adverse effect on the ipsilateral ovary has been proposed (Lass et al., 1998). "
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    Human Reproduction 01/2002; 17(1):128-133. DOI:10.1093/humrep/17.1.128 · 4.57 Impact Factor
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