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J Turk Ger Gynecol Assoc. 2018 Oct 26. doi: 10.4274/jtgga.2018.0087. [Epub ahead of print]

Post-partum tubal ligation at time of cesarean delivery or via laparoscopy as an interval sterilization has similar effects on ovarian reserve

Author information

1
Ankara University School of Medicine Obstetrics and Gynecology Department Ankara, Turkey

Abstract

Objective:

To observe and compare the effect of postpartum tubal ligation procedures on ovarian reserve at women desiring tubal ligation as a contraceptive method at the end of pregnancy.

Material and Methods:

Eighty-one women were included in the prospective study. Tubal ligation (TL) was performed at time of cesarean delivery (CD) (n:49) and as an interval procedure by laparoscopy (LS) at postpartum period (n:32). Anti-mullerian hormone (AMH) was used to determine ovarian reserve. Blood samples were taken twice from each subject; first sample was taken before delivery from all subjects and second sample was taken 4 months after sterilization. AMH level differences were compared in each group and between groups.

Results:

The preoperative AMH values of CD and LS groups were similar 2.30 ng/ml (max 5.20, min0.42 ng/ml), 1.80 ng/ml (max3.50, min0.40 ng/ml ), respectively (P=0.262). The postoperative AMH values of CD and LS groups were 1.30 ng/ml (max 2.60, min 0.30 ng/ml), 0.90 ng/ml (max 2.50,min 0.20 ng/ml), respectively (P=0.284). When comparison is done for the preoperative and postoperative values of each group the change was statistically significant for both groups p<0.001. The decrease in mean AMH values in CD and LS groups were 37,83% and 44,15%, respectively. The percentage changes of AMH values were not statistically significant (p=0,286).

Conclusion:

Tubal ligation at time of CD and interval sterilization with LS have similar effects on ovarian reserve.

KEYWORDS:

Tubal ligation; ovarian reserve; anti-mullerian hormone; cesarean section; laparoscopy

PMID:
30362334
DOI:
10.4274/jtgga.2018.0087
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