Impact of unilateral and bilateral salpingectomy on ovarian reserve

Salpingectomy has been one of the most performed surgical procedures in gynecological practice worldwide. Common indications include ectopic pregnancy and salpingitis (for example symptomatic hydro or pyosalpinx). This rising trend in salpingectomy has been associated with a rising concern over its potentially damaging effect on ovarian reserve due to possible concomitant damage of ovarian blood supply given the proximity of tubal and ovarian arteries.

This is a prospective cohort Study including eighty cases of infertile women with a previous unilateral or bilateral hydro salpinx and indicated for salpingectomy or tubal ligation attending the outpatient clinic at assisted reproduction unit, Al-Azhar University. The results were obtained in the period from February 2020 to December 2022.

The present study was conducted on 80 patients. The mean and (SD) values for age were 25.5 (5.2) years old with a minimum of 18 and a maximum of 34 years old. More than half of patients (58.8%) had bilateral Hydrosalpinx while 41.2% had unilateral hydrosalpinx. Whether preor post-operatively, there was no statistically significant difference between median number of antral follicles in patients with unilateral and bilateral hydrosalpinx. There was no statistically significant change in the mean of AMH levels post-operatively (p-value=0.147, effect size=0.035) in both unilateral and bilateral groups. There was no statistically significant change in median number of Antral follicles post-operatively (p-value=0.456, Effect size=0.167) in both unilateral and bilateral groups.

The unilateral and bilateral salpingectomy in patients with normal ovaries has no detrimental effect on ovarian reserve.