Effect of salpingectomy for tubal ectopic pregnancy on ovarian reserve

• Research type

  Research Study

• Full title

  Impact of salpingectomy methodologies for tubal Ectopic Pregnancy on ovarian reserve - A Prospective Study

• IRAS ID

  221874

• Contact name

  Kamal Ojha

• Contact email

  kamal.ojha@stgeorges.nhs.uk

• Sponsor organisation

  St. George's University Hospitals NHS Foundation Trust

• Duration of Study in the UK

  1 years, 0 months, 1 days

• Research summary

  This study aims to assess the long-term effects of different salpingectomy methodologies following tubal ectopic pregnancy on ovarian reserve. Although a third of ectopic pregnancies resolve without medical intervention, two thirds require surgical interventions, resulting in the removal of the fallopian tube containing the ectopic pregnancy. Mechanical and thermal methods are used to remove the fallopian tube, and we hypothesise that these methods may cause differential damage to blood supply to the ovary and thus impact fertility. Previous studies have shown that following surgical removal of tubal ectopic pregnancies, women display a significantly lower chance of conception in comparison to the general population. However, whether the causality is via direct damage from the surgical procedure to the ovary remains unknown. This study will analyse all patients diagnosed with a tubal ectopic pregnancy from St George’s Hospital Trust Early Pregnancy and Acute Gynaecology Unit, establishing each patient’s ovarian reserve at the time of diagnosis to gain a baseline of their fertility and following salpingectomy in three ways:
  1. Antral follicle count, assessed during the early follicular phase of the menstrual cycle.
  2. Blood tests for anti-mullerian hormone, a known clinical marker of ovarian reserve.
  3. Ovarian blood flow with a 3D transvaginal ultrasound scan.
  These tests will be conducted at the time of diagnosis, and repeated at 4 months, 12 months and 24 months post-surgery. The effects of the salpingectomy method employed will also be explored using histology of the removed fallopian tube to visualise the extent of cellular damage and immunohistochemistry to look at key markers of cell death. The data collected will provide key data regarding the methods used for salpingectomy, and inform clinical practice based on outcomes. Funding will be obtained from the lead applicant

• REC name

  London - Bromley Research Ethics Committee

• REC reference

  17/LO/0329

• Date of REC Opinion

  28 Apr 2017

• REC opinion

  Further Information Favourable Opinion