Hormonal and ovarian stromal blood supply changes after laparoscopic tubal sterilization: a prospective controlled study.
OBJECTIVE
The purpose of this study is to determine if the effects of tubal sterilization (TS) by laparoscopy have any risk of a subsequent significant decrease in ovarian reserve and vascular support within the ovary by means of stromal artery Doppler study, and to compare the results with matched paired controls.


METHODS
Between February 2002 and January 2005, 148 healthy volunteers were enrolled sequentially, 74 undergoing laparoscopic TS (study group) and 74 age-, parity-, body mass index-matched women were recruited as a control group. The main outcome measurements were blood levels of follicle-stimulating hormone (FSH), luteinizing hormone and E2, ovarian volume, number of antral follicles and Doppler study of ovarian stromal artery pulsatile index (PI) and maximum velocity (Vmax) on the third day of the cycle immediately before, and 1 and 12 months after the surgical intervention.


RESULTS
There were significant elevations in both serum FSH levels and PI values observed 1 month after TS, compared to the preoperative levels (p < .05), and also when compared to controls. However, there were no significant elevations at 12 months postoperation in both study and control groups. The other outcome measurements did not show any significant differences between the two groups.


CONCLUSIONS
Tubal sterilization by laparoscopic electrocoagulation does not cause any decrease in ovarian reserve or ovarian stromal blood supply, except an early postoperative increase in FSH and PI.
Kelekci
Sefa
S
Family Planning Unit, Suleymaniye Maternity Hospital, 34340 Istanbul, Turkey. sefamed@hotmail.com
Yilmaz
Bulent
B
Yakut
Yasemin
Y
Yasar
Levent
L
Savan
Kadir
K
Sonmez
Suha
S
D000328:Adult; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007986:Luteinizing Hormone / Q000097:blood*; D010053:Ovary / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000378:metabolism; D011446:Prospective Studies; D012039:Regional Blood Flow; D013246:Sterilization, Tubal / Q000379:methods; D018615:Ultrasonography, Doppler, Color
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone