Impact of tubal ligation on ovarian reserve as measured by anti-Müllerian hormone levels: a prospective cohort study

Abstract Background Tubal ligation (TL) is considered a very efficient contraceptive method. However, some patients complain of a variety of postoperative symptoms. The objective of this study was to investigate whether ovarian reserve may change after tubal ligation. Study Design This was a prospec...

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Published in:Contraception (Stoneham) 2013-12, Vol.88 (6), p.700-705
Main Authors: da Silva, Ana Luiza Berwanger, da Ré, Camila, Dietrich, Cristine, Fuhrmeister, Isabela Piva, Pimentel, Anita, Corleta, Helena Von Eye
Format: Article
Language:English
Subjects:
Adult
Anti-Mullerian Hormone - blood
Anti-Müllerian hormone
Biological and medical sciences
Birth control
Cell Count
Female
Genital system. Reproduction
Gynecology. Andrology. Obstetrics
Hormonal contraceptives
Humans
Medical sciences
Obstetrics and Gynecology
Other methods of contraception. Sterilization
Ovarian Follicle - cytology
Ovarian Follicle - diagnostic imaging
Ovarian reserve
Pharmacology. Drug treatments
Prospective Studies
Sterilization, Tubal
Tubal ligation
Ultrasonography
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Summary:Abstract Background Tubal ligation (TL) is considered a very efficient contraceptive method. However, some patients complain of a variety of postoperative symptoms. The objective of this study was to investigate whether ovarian reserve may change after tubal ligation. Study Design This was a prospective cohort study of 80 fertile women who underwent TL. Ovarian reserve was evaluated by measuring pre- and postoperative (1 year after surgery) serum anti-Müllerian hormone (AMH) levels and transvaginal antral follicular count (AFC). Potential confounding factors were age, body mass index (BMI), smoking, surgical technique and prior contraceptive methods. The Wilcoxon test was used to compare pre- and postoperative (12 months) AMH and AFC, and simple and multiple linear regression were used to evaluate confounding factors. Results Fifty-two patients completed the study protocol. The median AMH level was 1.43 ng/mL (interquartile range 0.63–2.62) preoperatively and 1.30 ng/mL (interquartile range 0.53–2.85) after 12 months (p=.23). The mean AFC was 8.0 (interquartile range 5.0–14.0) and 11.0 (interquartile range 7.0–15.0) before and after TL, respectively (p=.12). These differences were not statistically significant. Use of a hormonal contraceptive method prior to TL was significantly associated with a postoperative increase in AMH. Conclusions This study suggests that ovarian reserve is not altered by TL.
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2012.09.021