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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

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



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.


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).


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


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

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