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.
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