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GYNECOLOGY

A retrospective analysis of the effect of

salpingectomy on serum antiMullerian
hormone level and ovarian reserve
Xu-ping Ye, BS; Yue-zhou Yang, MS; Xiao-xi Sun, MD
OBJECTIVE: To determine whether previous salpingectomy is associated with serum antiMullerian hormone (AMH) level and ovarian
reserve in women under 40 years presenting for in vitro fertilization
and embryo transfer.
STUDY DESIGN: We retrospectively compared serum AMH levels
measured on the ovulation induction initiation day in patients with
unilateral salpingectomy, bilateral salpingectomy, and no tubal surgery, and examined the relationship with length of time after surgery
and in vitro fertilization and embryo transfer parameters.
RESULTS: A total of 198 women were included; 83 received unilateral

salpingectomy, 41 bilateral salpingectomy, and 74 no tubal surgery.

The baseline characteristics of the groups were similar. The mean
AMH level was significantly higher in women without tubal surgery as
compared with those with bilateral salpingectomy (183.48 vs
127.11 fmol/mL; P
.037). The mean follicle stimulation hormone
level was significantly lower in women without surgery as compared

with those with bilateral salpingectomy (7.85 vs 9.13 mIU/mL;

P .048). No significant differences in duration of gonadotropin
therapy, amount of gonadotropin used, estradiol level on the human
chorionic gonadotropin injection day, thickness of the endometrium,
number of oocytes retrieved, number of 2-pronuclei, viable embryos,
and good quality embryos were found between the 3 groups. AMH
level was not correlated with the number of oocytes or age in women
that had undergone unilateral or bilateral salpingectomy.
CONCLUSION: Salpingectomy is associated with decreased AMH level

and increased follicle stimulation hormone in women seeking in vitro

fertilization, though AMH level is not correlated with the number of
oocytes retrieved in patients that have undergone unilateral or bilateral
salpingectomy. These results suggest that salpingectomy is associated with decreased ovarian reserve.
Key words: AMH, antiMullerian hormone, IVF-ET, ovarian reserve,
salpingectomy

Cite this article as: Ye X, Yang Y, Sun X. A retrospective analysis of the effect of salpingectomy on serum antiMullerian hormone level and ovarian reserve. Am J Obstet
Gynecol 2015;212:53.e1-10.

t is generally recognized that removal

of a hydrosalpinx can increase the
implantation rate of in vitro fertilization
and embryo transfer (IVF-ET).1,2 However, whether salpingectomy affects
ovarian reserve is uncertain, with some
studies suggesting that salpingectomy
deceases ovarian reserve,3-5 and other
studies indicating that it has no effect
on ovarian reserve.6-9 Various studies,
however, have used different measures of
From Obstetrics and Gynecology Hospital of
Fudan University Shanghai (Ms Ye and Dr Sun)
and the Genetic and IVF Center of Shanghai Jiai,
Shanghai (Mr Yang and Dr Sun), China.
Received Feb. 21, 2014; revised June 11, 2014;
accepted July 15, 2014.
The authors report no conict of interest.
Corresponding author: Yue-zhou Yang, MS.
yyzu@163.com
0002-9378/$36.00
2015 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.ajog.2014.07.027

ovarian reserve including the duration of

gonadotropin stimulation, amount of
gonadotropin used, number of follicles,
number of oocytes retrieved, fertilization
rate, implantation rate, clinical pregnancy rate, live birth rate, and antiMllerian hormone (AMH) level.
AMH is a glycoprotein dimer secreted
primarily by granulocytes of preantral
follicles and small antral follicles.10
AMH levels are relatively constant throughout the menstrual cycle,11 correlate
with the number of follicles and ovarian
reserve,12-14 and are predictive of both
over and poor response to controlled
ovarian stimulation.15,16 For these reasons, AMH levels can be used to evaluate changes in ovarian reserve after
salpingectomy.
The purpose of this study was to
determine whether previous salpingectomy is associated with serum AMH level
and ovarian reserve in women under
40 years of age presenting for IVF-ET.

P ATIENTS

AND

M ETHODS

Patients
IVF-ET patients who visited Shanghai
Ji Ai Genetics and IVF Institute and
the Obstetrics and Gynecology Hospital
of Fudan University between October
2012 and May 2013 were eligible for inclusion in this study. Inclusion criteria
were age <40 years, regular menstrual
cycles, and no history of ovarian surgery.
Women with polycystic ovarian syndrome, ovulatory dysfunction, and
endometriosis were excluded from the
analysis. Subjects were assigned into 1 of
3 groups according to their history of
preIVF tubal surgery: unilateral salpingectomy, bilateral salpingectomy, or
no tubal surgery. The institutional review
board approved this retrospective study.
Measurement of hormone levels
A 10-mL blood sample was drawn on
the third day of menstruation (IVFET initiation day). The sample was

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centrifuged for 5 minutes, and the supernatant serum was collected and
stored at 20 C. Before testing, the
sample was thawed and vortexed.
Estradiol (E2), progesterone, luteinizing
hormone, and follicle stimulating hormone (FSH) levels were measured with a
Beckman Acoulter Access automated
chemiluminescence
immunoassay
analyzer with reagent kits from Beckman
(BeckmaneCoulter Inc., Brea, CA).
Testing was performed according to the
manufacturers instructions. AMH levels
were measured by an enzyme linked
immunosorbent assay using a Bio-Rad
iMark microplate absorbance reader
with reagent kits from Bio-Rad (Bio-Rad
Laboratories Inc, Hercules, CA). Per the
manufacturer, the interassay coefcient
of variability is
10%, and the intraassay
coefcient of variability is
15%.

Determination of antral follicle count

On the third day of menstruation (IVFET initiation day), transvaginal sonography was performed to evaluate the
status of the uterus and ovaries, measure
the ovarian size, and determine the
antral follicle count (AFC). A Philips
HDII ultrasonography machine (Philips,
Amsterdam, the Netherlands) was used
at a probe frequency of 3w7 MHz.
Ovulation induction and IVF protocols
Short controlled ovarian
hyperstimulation protocol
Daily subcutaneous triptorelin 0.1 mg
was given from the third day of menstruation to the day of human chorionic
gonadotropin (hCG) injection. Gonadotropin 75-300 IU/day by injection was
started on the fourth day, and adjusted
according to ultrasonography results
and serum E2 level.
Minimal ovarian stimulation protocol
Oral clomiphene 50-100 mg was given
from the third day of menstruation to
the day of hCG injection. Daily human
menopausal gonadotropin 75-150 IU
by injection was given starting on the
fth day of clomiphene. When 1 dominant follicle reached 18 mm in diameter,
or 2 follicles reached 16 mm in diameter,
intramuscular injection of hCG 300010000 IU was given. Oocytes were

retrieved under transvaginal ultrasonography guidance within 34-36 hours

of hCG injection.
IVF
Quality sperm was selected for IVF/
intracytoplasmic sperm injection. Eighteen hours after fertilization, the oocyte
was observed to conrm the formation
of a pronucleus. After 3 days of culture,
the embryo was observed and scored
under a microscope.
Evaluation of embryo quality
Embryos of class I-III were considered
viable. Good quality embryos were dened
as having a normal cleavage rate, evensized blastomeres, and fragments <10%.

Statistical analysis
Continuous variables were presented as
means and standard deviations (SDs).
Categorical variables were presented as
counts and percentages. One-way analysis of variance with Bonferroni post hoc
testing was performed to compare the
differences between women with unilateral salpingectomy, with bilateral salpingectomy, and without surgery with
respect to baseline characteristics and
treatment-related factors. Because the
variables were normally distributed,
Pearson coefcient correlation (r) was
performed to investigate the linear correlation between AMH vs time after
surgery, number of oocytes, and age in
women with unilateral salpingectomy
and bilateral salpingectomy. A 2-sided
P value < .05 was considered to indicate statistical signicance. All statistical
analyses were performed with SPSS
17.0 statistics software (SPSS Inc.,
Chicago, IL).

R ESULTS
Patient characteristics
A total of 198 women were included
in the study, with 83 in the unilateral
salpingectomy group, 41 in the bilateral
salpingectomy group, and 74 in the
group that had not received tubal surgery. Patient characteristics by group
are shown in Table 1. There were no
differences in age, E2, progesterone,
luteinizing hormone, AFC, ovarian
stimulation protocol used, the length of

53.e2 American Journal of Obstetrics & Gynecology JANUARY 2015

secondary infertility, and the reason of

infertility between the 3 groups (all, P >
.05). The mean AMH level was signicantly higher in women without tubal
surgery as compared with those with
bilateral salpingectomy (183.48 vs
127.11 fmol/mL, P
.037). The mean
FSH level was signicantly lower in
women without surgery as compared
with those with bilateral salpingectomy
(7.85 vs 9.13 mIU/mL, P .048). The
mean duration of primary infertility was
signicantly higher in women without
surgery as compared with those with
unilateral and bilateral salpingectomy
(3.6 vs 0.31 and 0.82 years, P < .001).
The reasons for having surgery were
signicantly different between the unilateral and bilateral salpingectomy
groups. The percentage of patients with
an ectopic pregnancy was greater in the
unilateral salpingectomy group, and the
percentage of patients with a hydrosalpinx was greater in the bilateral salpingectomy group (Table 1).
The comparisons of treatment-related
factors between the three groups are
shown in Table 2. No signicant differences in duration of gonadotropin therapy, amount of gonadotropin used,
E2 level on the hCG injection day,
thickness of the endometrium, number
of oocytes retrieved, number of 2-pronuclear zygote (2PN), viable embryos,
and good quality embryos were found
between the 3 groups (all, P > .05).

Correlation between AMH level

and time after surgery and number
of oocytes
The correlations between AMH level and
time after surgery, number of oocytes,
and age for women with a unilateral
salpingectomy are shown in Figure 1,
and the correlations for women with a
bilateral salpingectomy are shown in
Figure 2. For women with a unilateral
salpingectomy, a signicant linear correlation was found between AMH level
and time after surgery (r 0.399, P <
.001) (Figure 1, A). No signicant linear
correlations were found between AMH
and number of oocytes (r 0.145, P
.192) and age (r 0.141, P .202)
(Figure 1, B and C, respectively). For
women with a bilateral salpingectomy,

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TABLE 1

Patient characteristics
Characteristic

Unilateral salpingectomy
(n [ 83)

Bilateral salpingectomy
(n [ 41)

Without surgery
(n [ 74)

P value

33.02  4.66

33.58  3.95

167.56  127.03

127.11  93.23

183.48  104.37

38.3  14.91

41.41  16.59

36.49  16.77

.291

Progesterone, nmol/L

0.52  0.29

0.55  0.33

0.54  0.32

.848

LH, mIU/mL

4.06  1.56

3.94  1.75

4.26  2.09

.63

FSH,

8.42  2.3

9.13  3.2

7.85  2.69y

.048

10.7  3.62

9.58  3.73

Age, y
AMH, (fmol/mL)
E2, pg/mL

AFC,

33.8  4.67

.553
a

.037

11.22  4.16

.097

BMI, kg/m

21.63  2.46

21.1  2.85

21.43  2.83

.582

Testosterone

38.59  13.42

32.55  9.86

37.42  18.02

.152

Short COH

52 (62.65)

17 (41.46)

38 (51.35)

Minimal ovarian stimulation

31 (37.35)

24 (58.54)

36 (48.65)

Protocol

.071

< .001

Reason for surgery

Tuboovarian abscess
Ectopic pregnancy
Hydrosalpinx

1 (1.2)

1 (2.44)

79 (95.18)

24 (58.54)

3 (3.61)

16 (39.02)

Primary infertility, y

0.31  1.13

0.82  1.96

3.6  4.15a,b

Secondary infertility, y

2.85  2.81

3.23  3.24

2.36  3.32

.369

0 (0)

0 (0)

2 (2.7)

.184

< .001

Reason of infertility
Unknown
Oligoasthenoteratospermia
Severe oligoasthenoteratospermia
Obstructive azoospermia
Both male and female factors

41 (49.4)

15 (36.59)

28 (37.84)

.239

2 (2.41)

1 (2.44)

6 (8.11)

.178

2 (2.41)
28 (52.83)

0 (0)
15 (55.56)

4 (5.41)

.245

26 (55.32)

.959

Data are presented as meanstandard deviation or count (percentage).

AFC, antral follicle count; AMH, antiMullerian hormone; BMI, body mass index; COH, controlled ovarian hyperstimulation; E2, estradiol; FSH, follicle stimulating hormone; LH, luteinizing hormone.
a

P < .05, significantly different with unilateral salpingectomy group; b P < .05, significantly different with bilateral salpingectomy group.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

no signicant linear correlations were

found between AMH level and time after
surgery (r 0.049, P .760), number
of oocytes (r 0.180, P .260), and age
(r 0.277, P .079) (Figure 2, A, B,
and C, respectively). Signicant linear
correlations were found between AFC
and number of oocytes in women with
a bilateral salpingectomy, but not with
unilateral salpingectomy (bilateral: r
0.348, P .028; unilateral: r 0.026,
P .815) (Appendix; Supplemental
Figures 1 and 2). No signicant linear

correlations were found between

AMH level and AFC in women with a
unilateral salpingectomy (r 0.013,
P .904) or with a bilateral salpingectomy (r 0.274, P .087) (Supplemental Figures 3 and 4). No signicant
linear correlation was found between
AMH level and age in all women
(r 0.067, P .352) (Supplemental
Figure 5). A signicant linear correlation
was found between AMH level and age
in women without surgery (r 0.273,
P .019) (Supplemental Figure 6).

C OMMENT
The results of this study showed that
AMH level was lower and FSH was
higher in women that received a bilateral
salpingectomy than in those that had
not received tubal surgery, although the
AFC was similar between the 3 groups.
In patients that had received a unilateral
salpingectomy, AMH was correlated
with time after surgery but not with age
or number of oocytes retrieved and
there was no correlation between AFC
and number of oocytes retrieved. In

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TABLE 2

Patient treatment-related factors

Variable

Unilateral salpingectomy
(n [ 83)

Bilateral salpingectomy
(n [ 41)

Without surgery
(n [ 74)

P value

9.6  1.76

9.39  2.12

9.78  1.62

.523

23.75  10.31

23.77  10.79

24.95  9.85

.732

3822.99  1630.06

3286.05  1629.64

3727.36  1891.94

.257

Thickness of endometrium, mm

9.84  3.3

8.98  2.58

9.84  2.95

.27

Number of oocytes retrieved

7.83  4.16

6.98  4.15

8.42  4.04

.199

Number of 2-pronuclear zygote

4.95  3.43

4.76  3.61

5.49  3.06

.453

Number viable embryos

3.39  3.03

3.15  2.51

3.5  2.6

.807

Number of good quality embryos

2.72  2.69

2.44  2.24

2.69  2.39

.826

Duration of Gn therapy, d
Gn amount (vials)
E2 level on the hCG injection day, pg/mL

Data reported as mean  standard deviation.

Gn, gonadotropin; E2, estradiol; hCG, human chorionic gonadotropin.
Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

patients with a prior bilateral salpingectomy, AMH was not correlated with age,
time after surgery, or number of oocytes

retrieved, although AFC was correlated

with the number of oocytes retrieved.
AMH and AFC were not correlated in

FIGURE 1

Correlations of AMH level in women with unilateral salpingectomy

A, Correlation between AMH and time after surgery in women with unilateral salpingectomy.
B, Correlation between AMH and number of oocytes in women with unilateral salpingectomy.
C, Correlation between AMH and age in women with unilateral salpingectomy.
AMH, antiMullerian hormone.
Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

53.e4 American Journal of Obstetrics & Gynecology JANUARY 2015

either the unilateral or bilateral salpingectomy groups, and AMH was not
correlated with age in all women but
correlated with age in the women that
had not received tubal surgery. There
were no signicant differences in duration of gonadotropin therapy, amount
of gonadotropin used, E2 level on the
hCG injection day, thickness of the
endometrium, number of oocytes
retrieved, number of 2PN, viable embryos, and good quality embryos between patients with unilateral or
bilateral salpingectomy or those with
no tubal surgery.
The fallopian tube is an essential
component of the female reproductive
system. The ovary is supplied by the
ovarian artery, but also by the ascending
branch of the uterine artery in the mesosalpinx. Some authors have reported
that salpingectomy reduces the ovarian
blood supply, and therefore compromises ovarian reserve.4,6 In our previous
study,17 we compared the outcomes of
controlled ovarian hyperstimulation
between patients before and after salpingectomy and found that unilateral
salpingectomy had little effect on
ovarian response to hyperstimulation
therapy, although bilateral salpingectomy was associated with reduced
ovarian sensitivity to gonadotropin, increased duration of gonadotropin therapy, and increased amount of
gonadotropin used. In the current study,

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FIGURE 2

Correlations of AMH level in women with bilateral salpingectomy

A, Correlation between AMH and time after surgery in women with bilateral salpingectomy.
B, Correlation between AMH and number of oocytes in women with bilateral salpingectomy.
C, Correlation between AMH and age in women with bilateral salpingectomy.
AMH, antiMullerian hormone.
Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

there were no statistically signicant

differences in days of gonadotropin use,
amount of gonadotropin used, E2 level
on the hCG day, thickness of the endometrium, and the number of 2PN, viable
embryos, and good quality embryos between patients that had received a unilateral or bilateral salpingectomy or had
not received tubal surgery; however,
there was a stepwise trend among them.
Fewer oocytes were retrieved from patients who had received a bilateral salpingectomy as compared with those
without tubal surgery. Although the results of this and our prior study are not
identical, they show a similar trend.
Lin et al9 examined 288 consecutive
fresh IVF-ET cycles in 251 women who
had either laparoscopic salpingectomy
or prior bilateral tubal sterilization, laparoscopic tuboplasty, or proximal tubal
occlusion, and reported no difference

in any ovarian response parameters

between the salpingectomy and nonsalpingectomy groups, and similar implantation rates, clinical pregnancy rates,
and live birth rates. In addition, the
mean number of follicles and oocytes
retrieved ipsilateral to the operated side
in the salpingectomy group were similar
to that from the nonoperated ovary.
Other authors have also reported that
salpingectomy does not affect ovarian
reserve or ovarian response to gonadotropin stimulation.7,8,18 On the other
hand, Lass et al3 reported that in patients
undergoing IVF-ET who had received a
prior salpingectomy signicantly fewer
follicles developed and fewer oocytes
were retrieved from the ovary on the
operated side as compared with the
nonoperated side. There was, however,
no difference in the total number of
follicles and oocytes retrieved from

Research

both ovaries, cycle characteristics, and

pregnancy rates between patients that
had a prior salpingectomy and those
with unexplained or male factor
infertility.
We believe that salpingectomy undermines the ovarian reserve. Because
salpingectomy interrupts the ovarian
blood supply from the ascending branch
of the uterine artery, the ovary receives
less pituitary hormones, nutrition,
and medication associated with IVF-ET
therapy. As a result, ovarian sensitivity
to gonadotropin is reduced leading to
poorer IVF-ET outcomes. Previous
studies have indirectly assessed the
impact of salpingectomy on ovary
function by comparing IVF-ET outcomes, and inconsistency in the literature may be due to the many variable
factors during IVF-ET treatment and
different salpingectomy approaches.
In addition to IVF-ET outcomes,
other commonly used indicators of
ovarian reserve include age, basal FSH
levels, and AFC; however, their predictive ability can vary. AMH is a glycoprotein dimer and transforming growth
factor that regulates follicular recruitment and development.19 Serum AMH
levels in premenopausal women are
relatively constant, and do not vary with
the different phases of the menstrual
cycle.11,13,20 In addition, oral contraceptives have little impact on serum
AMH level.21,22 Therefore, AMH level,
as compared with traditional measures, is a superior indicator of ovarian
reserve.11-14,19-22 AMH levels have been
shown to correlate with the number of
oocytes retrieved and percentage of MII
oocytes in patients undergoing IVFET.23 Another study has shown that
follicular uid AMH level is positively
correlated with follicle sensitivity to
FSH,24 and has suggested that there is
an association between follicular uid
AMH level and the quality of embryos
in polycystic ovarian syndrome patients
undergoing IVF-ET.25 Lin et al26 reported that AMH level was correlated
with good quality embryos and blastocysts in patients undergoing IVF-ET,
and that follicular uid AMH level
correlated with the clinical pregnancy
and live birth rates.

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In the current study, the patients in

the 3 groups were of similar age, and thus
their basal hormone levels and AFC were
comparable. The results showed that on
the initiation day of ovulation induction,
there was a stepwise decrease in serum
AMH levels from patients without tubal
surgery to patients with unilateral salpingectomy, and from patients with
unilateral salpingectomy to patients with
bilateral salpingectomy (P < .05). AMH
is secreted primarily by granulocytes
of preantral follicles and small antral
follicles.10 With a decreased ovarian
blood supply after salpingectomy, the
recruitment and development of follicles
is compromised, leading to reduced
AMH secretion from follicular granulocytes. This phenomenon may explain
the cause of reduced serum AMH levels
after salpingectomy. Patients with bilateral salpingectomy had a lower AFC than
those without tubal surgery, whereas
there was no statistically signicant difference in AFC between patients with
unilateral salpingectomy and those
without tubal surgery. In addition, FSH
level was greater in the bilateral salpingectomy group than in the group
that had not received tubal surgery.
Taken together, these data suggest that
salpingectomy affects ovarian reserve.
To elucidate whether ovary function
is restored after unilateral salpingectomy
through compensation of the blood
supply from the ovarian artery, we conducted a correlation analysis between
the duration after unilateral salpingectomy and AMH levels, and the analysis
revealed AMH level was correlated
with time after surgery, but there was
no correlation with age and number of
oocytes retrieved. In the bilateral salpingectomy group, there was no correlation between AMH level and time
after surgery, age, or number of oocytes
retrieved. Interestingly, Findley et al27
compared AMH levels in patients who
received bilateral salpingectomy or no
salpingectomy at the time of laparoscopic hysterectomy with ovarian preservation and found no difference in
AMH levels between the 2 groups at
3 months postoperatively, and no decrease in AMH level from the baseline
value in either group. Their study, as

stated, only examined levels at 3 month

after surgery.
Studies comparing AMH and AFC
typically see a correlation of AMH with
AFC and with the number of oocytes
retrieved. In the current study, AFC
was only correlated with the number of
oocytes retrieved in the bilateral salpingectomy group; no correlation was
seen in the unilateral group and no
correlation between AMH and number
of oocytes was seen in either the unilateral or bilateral groups. In addition, a
signicant correlation between AMH
level and age in women that had not
received surgery was seen, but no correlations with age were seen in the salpingectomy groups. The reasons for
these nding are difcult to determine.
In the present study, serum AMH was
used for analysis, not follicle uid AMH,
which may reect the AMH stimulation
status more directly. There are also some
reports that indicate that AMH might
not be associated with oocytes numbers,
and the possible reasons might be related
to complicated communication pathways and the effects of hormones, and
the detailed interactions still require
further study.26,28,29 To consider whether
this may be due to the different populations assessed, we analyzed whether
AMH level, oocyte number, and AFC
differed according to the reason for
surgery and found no signicant differences (data not shown). In addition,
changes of AMH with aging may differ
with ethnic background.30
There are some limitations to this
study that should be considered. The
number of patients was relatively small,
and a post hoc power analysis indicated
that the calculated power was <0.8,
the standard of adequacy, for most variables. AMH levels before salpingectomy
were not available. We did not examine
other IVF-ET outcomes such as implantation, clinical pregnancy, and live
birth rates. Patients that choose the short
induction protocol at our institution
almost all desire to freeze the embryos
with implantation some years later.
Thus, pregnancy outcome data are not
available. Different ovarian induction
protocols were used making it difcult
to compare variables such as dosages of

53.e6 American Journal of Obstetrics & Gynecology JANUARY 2015

gonadotropins and oocytes retrieved.

However, both are short protocols and
are known to have similar effects. Lastly,
the mean age of the study population is
low in comparison with that of women
in most countries applying for IVF. At
our institution, many women choose to
undergo ovulation induction and IVF
and freezing soon after surgery such
that the mean age of patients is lower
than that typically seen in studies of
this nature.

C ONCLUSIONS
Salpingectomy is associated with decreased AMH level and increased FSH
in women seeking IVF, though AMH
level is not correlated with the number
of oocytes retrieved in patients that
have undergone unilateral or bilateral
salpingectomy. Although the results
indicate an association, they should not
be interpreted as implying causation. REFERENCES
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2. Strandell A, Lindhard A, Eckerlund I. Costeffectiveness analysis of salpingectomy prior
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Hum Reprod 2005;20:3284-92.
3. Lass A, Ellenbogen A, Croucher C, et al.
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5. Grynnerup AG, Lindhard A, Srensen S. AntiMllerian hormone levels in salpingectomized
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7. Tal J, Paltieli Y, Korobotchka R, Ziskind G,
Eibschitz I, Ohel G. Ovarian response to
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8. Dar P, Sachs GS, Strassburger D,
Bukovsky I, Arieli S. Ovary function before
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9. Lin YJ, Ou YC, Huang FJ, et al. Ovarian
response to gonadotropins in patients with
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A PPENDIX

SUPPLEMENTAL FIGURE 1

Correlation between AFC and number of oocytes in women with unilateral

salpingectomy

AFC, antral follicle count.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

SUPPLEMENTAL FIGURE 2

Correlation between AFC and number of oocytes in women with bilateral

salpingectomy

AFC, antral follicle count.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

53.e8 American Journal of Obstetrics & Gynecology JANUARY 2015

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ajog.org

Gynecology

Research

SUPPLEMENTAL FIGURE 3

Correlation between AMH and AFC in women with unilateral

salpingectomy

AFC, antral follicle count; AMH, antiMullerian hormone.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

SUPPLEMENTAL FIGURE 4

Correlation between AMH and AFC in women with bilateral salpingectomy

AFC, antral follicle count; AMH, antiMullerian hormone.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

JANUARY 2015 American Journal of Obstetrics & Gynecology

53.e9

Research

Gynecology

SUPPLEMENTAL FIGURE 5

Correlation between AMH and age in all women

AMH, antiMullerian hormone.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

SUPPLEMENTAL FIGURE 6

Correlation between AMH and age in women without tubal surgery

AMH, antiMullerian hormone.

Ye. Salpingectomy and ovarian reserve. Am J Obstet Gynecol 2015.

53.e10 American Journal of Obstetrics & Gynecology JANUARY 2015

ajog.org