Controlled Clinical Trial Assessing the Effect of Laparoscopic Uterine Arterial Occlusion on Ovarian Reserve

Abstract 

Study Objective

To assess the effect on ovarian reserve function after laparoscopic uterine artery occlusion (LUAO) compared with laparoscopic surgery supracervical hysterectomy (LSH) and laparoscopic myomectomy (LM).

Design

Prospective cohort study (Canadian Task Force classification II-1).

Setting

Hospital with experience in gynecologic minimal access surgery.

Patients

Ninety patients with uterine myomas operated on from August through December 2007.

Intervention

Ninety patients were divided into 3 groups of 30 patients each: the study group underwent LUAO and myomectomy (LUAO-M), control group 1 underwent LSH, and control group 2 underwent LM only.

Measurements and Main Results

Blood samples were collected before surgery and at 1, 3, and 6 months postoperatively. Concentrations of follicle-stimulating hormone (FSH), leuteinizing hormone (LH), and estradiol (EZ) were determined using an immunoassay, and serum inhibin B (INHB) concentration was evaluated using an enzyme-linked immunosorbent assay. No significant differences in preoperative hormone concentrations between the 3 groups were found (p >.05). In the LSH group, FSH, LH, and E2 concentrations were significantly increased, whereas the INHB concentration was significantly decreased at 1 month postoperatively (p <.05); after 3 months, only the INHB concentration was significantly decreased (p <.05). However, in the LOUA-M and LM groups, there were no significant differences between preoperative and postoperative hormone concentrations (p >.05). Serum concentrations of FSH, LH, and INHB in the LSH group were significantly different from those in the study group at 1 and 3 months postoperatively (p <.05); however, the differences in postoperative hormone concentrations between the study group and the LM group were not significant (p >.05).

Conclusion

At short-term follow-up, no significant effect on ovarian reserve in patients with myoma who underwent LUAO was found.

Keywords: Inhibit B, Laparoscopic uterine artery occlusion, Ovarian reserve function, Uterine myoma