Ovarian reserve and ovarian stromal blood supply after tubal ligation by the Pomeroy technique: comparison with controls.

OBJECTIVE

To determine if women who undergo tubal sterilization by the Pomeroy technique have any risk of a subsequent significant decrease in ovarian reserve and vascular support inside the ovary, by means of stromal artery Doppler ultrasonography.

METHODS

Between March 2000 and September 2004, 108 healthy volunteers underwent mini-laparatomic tubal ligation using the modified Pomeroy technique (study group). As a control group, 102 age-matched women were recruited. The main outcome measurements were blood levels of follicle-stimulating hormone (FSH), luteinizing hormone and estradiol, ovarian volume, number of antral follicles and Doppler indices of the ovarian stromal arteries on the third day of the cycle immediately before, 1 month and 12 months after the surgical intervention.

RESULTS

In the study group and control group, results of the main outcome measurements immediately before, 1 month and 12 months after the surgical intervention did not show any significant difference except one. There was a significant elevation of FSH levels after 1 and 12 months, which was statistically significant (p < 0.05) in the study group.

CONCLUSION

The 12-month follow-up of patients suggests that there is neither a decrease in ovarian reserve nor an adverse effect on the blood supply of ovarian stroma after tubal sterilization by the modified Pomeroy technique. A significant elevation of FSH levels was observed at 1 and 12 months after the operation.