Investigation of the Effect of Bilateral Salpingectomy on Serum Antimullerian Hormone Levels in Patients Undergoing Total Abdominal Hysterectomy for Benign Gynecologic Causes Article

Objective The goal of this research was to explore how intraoperative bilateral salpingectomy impacts ovarian reserve in individuals undergoing hysterectomy (TAHS due, to non cancerous reasons. Serum anti-Müllerian hormone (AMH) levels were used as the primary biomarker to evaluate ovarian reserve.

We selected 29 premenopausal patients aged 40-45 years who were scheduled for total abdominal hysterectomy for benign indications. Participants were allocated into two groups based on surgical preference: total abdominal hysterectomy only (TAH, n=15) and total abdominal hysterectomy with bilateral salpingectomy (TAH+BS, n=14). Serum AMH levels were measured in both groups preoperatively, on postoperative day 2 and at 1 month postoperatively. In addition, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were evaluated on day 3 of the menstrual cycle.

The mean age (TAH: 43.13±1.68, TAH+BS: 42.85±1.56, p=0.447) and BMI values (TAH: 29.22±4.03, TAH+BS: 27.35±5.60, p=0.280) of the groups were similar. Preoperative AMH levels were 1.14±0.78 ng/mL in the TAH group and 1.16±0.58 ng/mL in the TAH+BS group (p=0.906). Both groups demonstrated a significant decrease in AMH values during the postoperative period, with the nadir occurring on postoperative day 2. There was no significant difference between the groups in postoperative day 2 (TAH: 0.79±0.13, TAH+BS: 0.75±0.21, p=0.691) and 1-month (TAH: 0.94±0.78, TAH+BS: 0.92±0.58, p=0.377) measurements.

The addition of bilateral salpingectomy during hysterectomy had no additional negative effect on ovarian reserve compared to hysterectomy alone. This indicates that having both fallopian tubes removed can be done safely at the time, as a hysterectomy to lower the chances of developing cancer.