Long-term effects of opportunistic salpingectomy on the ovarian funcion: a prospective cohort study

Abstract

Background Ovarian cancer is the most lethal gynecologic malignancy. To date, no effective screening methods have been established to prevent this disease. Bilateral prophylactic salpingo-oophorectomy is indicated in high-risk women, who present mutations related to ovarian cancer. Due to the morbidity associated with the resection of the ovaries, this prevention method is not suitable for low-risk women. Opportunistic salpingectomy is favorable to salpingo-oophorectomy, as it avoids health risks associated with premature menopause after oophorectomy. Salpingectomy has been previously demonstrated to reduce the risk of ovarian cancer. However, whether salpingectomy affects ovarian function or not is controversial. Objectives Our main objective is to evaluate wether opportunistic salpingectomy has long-term effects on the ovarian reserve or not. Study design Our study is a multicentre prospective cohort study, with a consecutive method of sampling of patients attending Gynecology and Obstetrics Department of four hospitals in the Province of Girona. Population The study population will be women attending Gynecology and Obstetrics department, with benign pathology. A consecutive non-probabilistic method of sampling will be used to recruit the 452 patients needed. These patients will be divided into 2 groups, patients with indication of pelvic surgery will be considered as “exposed” and patients with no surgery indication will be considered as “not exposed”. Methods The main variable of this study is the ovarian function. We will compare AMH levels and AFC between our study group and our control group. In the case of our study group, both transvaginal ultrasound and blood sample obtention for AMH will be performed prior to surgery and 2 years after surgery. Regarding our control group, we will perform the same tests, in the same time interval