Changes in menstrual pattern and ovarian function following bipolar electrocauterization of the fallopian tubes for voluntary surgical contraception.

OBJECTIVE

Our aim was to investigate the changes in menstrual pattern, ovarian reserve and presence of dysmenorrhea and ovulation after tubal ligation via bipolar electrocautery.

METHODS

Sixty patients requesting voluntary tubal ligation were recruited in the study. Laparoscopic tubal sterilization via bipolar electrocoagulation was performed in all patients in the early follicular phase. Blood samples were collected on day 3, one cycle before the procedure, in the same cycle when the procedure was carried out and on the third cycle following the procedure for determination of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E(2)), and on day 21 for progesterone (P) levels. All patients were followed for 3 months, and changes in menstrual pattern, presence or absence of dysmenorrhea and ovulation were noted.

RESULTS

Menstrual changes occurred in six patients (10%), although only one patient had mild dysmenorrhea (1.6%) after the procedure. The incidence of ovulation was 33% preoperatively, rising to 40% in the cycle when surgery was performed and maintained a constant level at 40% 3 months after tubal ligation. There was no statistically significant difference in the serum FSH, LH and estradiol levels in preoperative and postoperative assessments (p > .05).

CONCLUSION

Tubal ligation has been blamed for causing luteal phase defect as a result of an effect on ovarian circulation. In our study, the rate of ovulation was slightly improved after the procedure, and ovarian reserve was not negatively affected. Bipolar electrocoagulation of the fallopian tubes did not alter the ovarian reserve and function.