Effects of salpingectomy during abdominal hysterectomy on ovarian reserve: a randomized controlled trial.

BACKGROUND: The aim of this study was to investigate the effect of salpingectomy on ovarian function by measuring AMH.

METHODS: This study was a balanced, single-center, double-blind, randomized, controlled trial in Ruin Tan Arash Hospital, Tehran, between May 2013 and November 2014. A total of 30 patients undergoing elective abdominal hysterectomy were randomized into two groups, 15 with salpingectomy and 15 without salpingectomy. The primary objective of this study was to compare mean difference of anti-Mullerian hormone (AMH) between two groups. The secondary outcomes measured were follicle-stimulating hormone (FSH), operative time, and blood loss.

RESULTS: Serum AMH levels decreased at 3 months after hysterectomy in all patients (pre AMH 1.32 ± (0.91); post AMH 1.05 ± (0.88), P  < 0.001), the salpingectomy group (pre AMH 1.44 ± (0.94); post AMH 1.13 ± (0.86), P  < 0.001), and no salpingectomy group (pre AMH 1.2 ± (0.9); post AMH 0.97 ± (0.92), P  < 0.001). The rate of decline of AMH levels after surgery did not differ between the two groups (25% (17-33%) vs. 26% (15-36%), P  = 0.23) among the women with salpingectomy versus without salpingectomy, respectively. There was no difference in the mean operative time (mean difference 0.33, 95% CI - 22.21 to 22.86, P  < 0.92), mean blood loss (mean difference - 0.66, 95% CI - 15.8 to 14.46, P  < 0.97), and post FSH (mean difference 0.34, 95% CI - 1.2 to 1.88, P  < 0.65) between both groups.

CONCLUSIONS: Salpingectomy with abdominal hysterectomy is a safe treatment that does not have a deleterious effect on ovarian reserve.

TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2014123118866N4 (www.IRCT.ir).