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

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 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 I, 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. Journal of Minimally Invasive Gynecology (2010) 17, 47-52 (C) 2010 AAGL. All rights reserved.