The effect of salpingectomy with preservation of the mesosalpinx on ovarian reserve function

Objective To investigate the impact of salpingectomy with preservation of fallopian tube mesentery on ovarian reserve function.

Methods A total of 281 patients with tubal disease who were admitted from January 2020 to March 2021 were collected as research objects. According to the different treatment methods, they were divided into traditional bilateral resection group (n=53, conventional bilateral salpingectomy), traditional unilateral resection group (n=56, conventional unilateral salpingectomy), preservation of bilateral resection group (n=60, bilateral salpingectomy with preservation of fallopian tube mesentery), preservation of unilateral resection group (n=54, unilateral salpingectomy with preservation of fallopian tube mesentery), and control groupn=58, patients with in vitro fertilization-embryo transfer (IVF-ET) but no history of salpingectomy. The operation time, intraoperative blood loss, and postoperative exhaust time were compared among the groups. Two months after the operation, IVF-ET was performed, and the number of follicles and oocytes, pregnancy rate, and fertilization rate were detected. The levels of anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), estradiol (E₂), and luteinizing hormone (LH) in peripheral blood were detected after IVF-ET. Follow-up was conducted until March 2023, and pregnancy success rates were recorded for the five groups.

Results There were no significant differences in perioperative operation time, intraoperative blood loss, and postoperative exhaust time among traditional bilateral resection group, traditional unilateral resection group, preservation of bilateral resection group, preservation of unilateral resection group (P>0.05). After IVF-ET, there were significant differences in AMH, FSH, E₂, and LH levels among the five groups (P < 0.05). The levels of AMH and E₂ in a rising sequence were traditional bilateral resection group, traditional unilateral resection group, preservation of bilateral resection group, preservation of unilateral resection group and control group, while the levels of FSH and LH in descending sequencing were traditional bilateral resection group, traditional unilateral resection group, preservation of bilateral resection group, preservation of unilateral resection group and control group. Follow-up was conducted until March 2023, and the pregnancy success rates after IVF-ET were 45.28%, 50.00%, 53.33%, 59.26%, and 58.62% in the traditional bilateral resection group, traditional unilateral resection group, preservation of bilateral resection group, preservation of unilateral resection group, and control group, respectively. There was no significant difference in pregnancy success rate after IVF-ET among the five groups (χ²=3.044, P=0.551).

Conclusion Compared with traditional salpingectomy, salpingectomy with preservation of fallopian tube mesentery has less impact on ovarian reserve function.