The effects of hysterectomy with bilateral salpingectomy on ovarian reserve

Abstract

Objective To determine whether ovarian reserve is compromised after hysterectomy with bilateral salpingectomy. Methods A prospective longitudinal study was conducted among 84 women who underwent hysterectomy with bilateral salpingectomy at a tertiary medical center in Beijing, China, between August 2, 2015, and January 15, 2017. Serum levels of anti‐Müllerian hormone (AMH) and follicle‐stimulating hormone (FSH) were measured to assess ovarian function before undergoing the procedure (baseline) and at weeks 1 and 6 after surgery (postoperative period). Results The median age was 41.61 ± 0.62 years. Age negatively correlated with the serum AMH level at baseline (P<0.001), as well as with preoperative‐to‐postoperative changes in the concentration of this hormone (P<0.001). Serum AMH levels were lower in the postoperative period versus the preoperative period (P<0.001). By contrast, serum FSH levels were higher in the postoperative period than in the preoperative period (P<0.001). Moreover, no correlation was found with body mass index. Conclusions Hysterectomy with bilateral salpingectomy compromised ovarian reserve, with the damage being most severe among younger patients.

Comparison of Postoperative Ovarian Reserve Function Following Laparoscopic Hysterectomy and Laparoscopic Myomectomy: A Prospective Comparative Pilot Study

“…In our data, ovary-and fallopian tube-sparing hysterectomies have a negative impact on ovarian reserve at 7 days postoperatively compared to myomectomy. Similar to our data, a recent prospective longitudinal study evaluating serum AMH and FSH levels in 84 women supports the notion that a hysterectomy with bilateral salpingectomy significantly compromises ovarian reserve, and the damage is more severe in younger women [6]. The authors reported that postoperative changes in serum AMH were significantly higher in the younger age group (younger than 35 years old) (p < 0.0001).…”

“…The authors reported that postoperative changes in serum AMH were significantly higher in the younger age group (younger than 35 years old) ( p < 0.0001). Moreover, postoperative serum AMH was significantly decreased ( p < 0.0001) and FSH was elevated ( p < 0.0001) from the baseline level [ 6 ]. However, they did not set the control group to compare the changes in AMH and FSH during the hysterectomy [ 6 ].…”

“…Moreover, postoperative serum AMH was significantly decreased ( p < 0.0001) and FSH was elevated ( p < 0.0001) from the baseline level [ 6 ]. However, they did not set the control group to compare the changes in AMH and FSH during the hysterectomy [ 6 ]. Another study comparing serum AMH levels after hysterectomy ( N = 35; abdominal or laparoscopic-assisted vaginal hysterectomy) to those after myomectomy ( N = 35; abdominal or laparoscopic myomectomy) revealed that the serum AMH level was significantly lower at 2 days and 3 months postoperatively following hysterectomy compared to the baseline level ( p < 0.01) [ 10 ].…”

“…Several studies supported that women who underwent ovary-sparing hysterectomy suffer from menopausal symptoms at a younger age because of the reduction in ovarian blood flow and follicular atresia [4,5]. A recent prospective study also supported that hysterectomy with bilateral salpingectomy significantly compromises ovarian reserve, and that the damage is more severe in younger women (<35 years old) [6].…”

Does Saving Uterus Save Ovaries?

“…So salpingectomy is a better option to prevent cancer risk rather than sacrificing ovaries. Yuan et al [18] concluded that hysterectomy with bilateral salpingectomy compromised ovarian reserve, with the damage being most severe among younger patients.…”