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Ma X, Sang S, Zhao Y, Wang X, Ji X, Shao S, Wang G, Xue F, Du Y, Lv M, Sun Q. High Prevalence of Asymptomatic Intracranial Atherosclerosis in Elder Women With Tubal Ligation: Result From a Community-Based Study in Shandong, China. Front Cardiovasc Med 2022; 9:830068. [PMID: 35310999 PMCID: PMC8924442 DOI: 10.3389/fcvm.2022.830068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/27/2022] [Indexed: 12/02/2022] Open
Abstract
Background In addition to traditional cardiovascular risk factors, gender-specific factors may also contribute to intracranial atherosclerosis. This study aimed to comprehensively investigate the association between asymptomatic intracranial atherosclerosis (aICAS) and menstrual or reproductive history (MRH), namely, menstruation, pregnancy, childbirth, menopause, and contraception. Methods Participants in this study were selected from the Kongcun town aICAS study. MRH was collected through structured case report forms, in which menarche age, menstrual regularity, dysmenorrhea, number of pregnancies, number of childbirths, age of first pregnancy, breastfeeding, menopause, menopause age, and contraceptive methods were all involved. All characteristics were compared by chi-squared and nonparametric tests as applicable. Logistic regression model and sensitivity analysis were used to analyze the association between aICAS and MRH. Results A total of 1,052 female participants were involved in this study, of which 5.7% had moderate to severe aICAS. Tubal ligation was significantly associated with aICAS in univariate analysis [crude odds ratio (OR), 2.85; 95% CI, 1.22–6.62; P = 0.015]. This association was still significant among female participants over 60 years old after multivariate adjustment (adjusted OR, 4.36; 95% CI, 1.55–12.24; P = 0.005). Sensitivity analysis showed a similar result (adjusted OR, 3.76; 95% CI, 1.24–11.41; P = 0.020). Menopause lost significant association with aICAS after multivariate adjustment (adjusted OR, 1.68; 95% CI, 0.66–4.24; P = 0.275). No other MRH factors were found to be associated with aICAS. Conclusion Tubal ligation may be associated with a higher prevalence of aICAS in Chinese elderly women. This provides a new perspective to study the epidemiological characteristics of ICAS.
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Affiliation(s)
- Xiaotong Ma
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shaowei Sang
- Department of Clinical Epidemiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuanyuan Zhao
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiaokang Ji
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Sai Shao
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ming Lv
- Department of Clinical Epidemiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Ming Lv
| | - Qinjian Sun
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Qinjian Sun
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Salman SG, Rafiq M. Effect of vaginal scrubbing on post-C-section infection. HAMDAN MEDICAL JOURNAL 2022. [DOI: 10.4103/hmj.hmj_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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The effect of bilateral tubal ligation on menopause age and symptoms. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.899875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ida T, Fujiwara H, Taniguchi Y, Kohyama A. Longitudinal assessment of anti-Müllerian hormone after cesarean section and influence of bilateral salpingectomy on ovarian reserve. Contraception 2021; 103:394-399. [PMID: 33539802 DOI: 10.1016/j.contraception.2021.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to compare longitudinal changes in ovarian reserve markers after cesarean section (CS) with and without bilateral salpingectomy (BS). STUDY DESIGN We prospectively enrolled women >35 weeks' gestation scheduled for CS alone or CS + BS and obtained blood samples for anti-Müllerian hormone prior to surgery and at 3 and 6 months after surgery. At the 3-month visit, we similarly performed transvaginal ultrasound for antral follicle count. RESULTS We enrolled 50 women; 30 underwent CS only and 20 underwent CS + BS. Although anti-Müllerian hormone level increased over 6 months of follow-up in both groups, no clinically important differences in the geometric mean (interquartile range) (ng/mL) were observed at any timepoint (baseline [0.69 {0.36-1.21} {CS only} vs 0.49 {0.32-2.10} {CS + BS}, p = 0.64]; 3 months [1.35 {0.58-3.13} vs 1.45 {1.04-2.25}, p = 0.79]; and 6 months [1.74 {0.93-4.45} vs 2.60 {1.41-5.10}, p =0.27]). Similarly, we detected no difference in antral follicle count. CONCLUSION BS at the time of CS does not have a negative impact on ovarian reserve 6 months after surgery. IMPLICATION While our results provide reassuring data that bilateral salpingectomy for permanent contraception at the time of cesarean section does not impact ovarian reserve, longer adequately powered studies are needed.
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Affiliation(s)
- Tsutomu Ida
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan.
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Yoshimi Taniguchi
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
| | - Akira Kohyama
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
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Knowledge of iatrogenic premature ovarian insufficiency among Chinese obstetricians and gynaecologists: a national questionnaire survey. J Ovarian Res 2020; 13:134. [PMID: 33208171 PMCID: PMC7677772 DOI: 10.1186/s13048-020-00739-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background With increasing cases of iatrogenic premature ovarian insufficiency (POI), more clinicians are required to counsel patients regarding the gonadotoxic effects of iatrogenic treatments. This survey aimed to explore obstetricians and gynaecologists’ knowledge regarding iatrogenic POI. A national online questionnaire survey was conducted across China. Respondents were asked to select the iatrogenic condition(s) that can cause POI based on their experience and knowledge. Results Of the 5523 returned questionnaires, 4995 were analysed. Among tumour therapies causing POI, most respondents agreed that radiotherapy (73.5% of respondents) and chemotherapy (64.1%) are risk factors for POI. While only 6.5 and 7.8% of the gynaecological oncologists believed that tumour immunotherapy and tumour-targeting therapy, respectively, may cause ovarian impairment, 31.8 and 22.2% of the non-gynaecologic oncologists believed that these therapies could affect ovarian health. Most respondents believed that ovarian cystectomy (54.4%) was a risk factor for POI. In contrast, only a few respondents believed that hysterectomy with bilateral salpingectomy (39.6%) and uterine artery embolisation (33.5%) could cause ovarian impairment. Only 30.5% of respondents believed that immunosuppressants (ISs) increased the risk of POI. Views differed with experience and hospital setting. Conclusions The knowledge of gonadal toxicity due to traditional tumour treatments is generally high among Chinese obstetricians and gynaecologists. A misunderstanding may exist in primary care hospitals and general gynaecologists regarding a link between novel tumour treatments and POI, owing to the lack of convincing evidence. Knowledge of POI caused by hysterectomy and ISs should be improved. Supplementary Information The online version contains supplementary material available at 10.1186/s13048-020-00739-z.
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Ahrari Khafi MS, Mogheiseh A, Salavati S, Karimi S. Angiography of ovarian and uterine vessels of the dog. Anim Reprod Sci 2018; 195:329-333. [DOI: 10.1016/j.anireprosci.2018.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 11/26/2022]
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Özkaya E, Gokmen O, Tosun A, Kucuk E, Baris S, Korkmaz V, Usta M. Unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years after fallopian tube ligation. Gynecol Endocrinol 2013; 29:559-62. [PMID: 23656384 DOI: 10.3109/09513590.2013.788633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM We sought to study the effect of tubal ligation on lipid profile, ovarian reserve and hot flashes during perimenopausal years. METHODS A total of 210 perimenopausal women complaining of abnormal vaginal bleeding were enrolled for the study. Subjects' menstrual, reproductive and medical histories were recorded. Serum FSH, LH and estradiol levels were screened in all women to determine menopausal status. In order to rule out any gynecologic pathology, all subjects underwent transvaginal sonography. Women were divided into two groups according to presence (study group, n = 68) or absence (control group, n = 142) of tubal ligation history. Lipid profiles and ovarian reserve tests were compared between groups. RESULTS Mean age, parity, serum hemoglobin (Hb), high density lipoprotein (HDL-C), triglyceride, estradiol levels, endometrial thickness and frequency of hot flashes were significantly different between groups (p < 0.05). Mean age was 42.8 ± 1.9 years in women with tubal ligation and 45.9 ± 3.5 years in control group. Mean serum estradiol level was lower in group with tubal ligation (41.4 versus 92.5 pg/ml). Mean endometrial thickness was higher in control group (10.2 versus 7.5 mm). Age-adjusted serum Hb, HDL-C, triglyceride, estradiol, FSH level, endometrial thickness and frequency of hot flashes remained significantly different between groups (p < 0.05). CONCLUSION Tubal ligation is associated with unfavorable lipid profile and higher frequency of hot flashes during perimenopausal years.
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Affiliation(s)
- Enis Özkaya
- Giresun University Faculty of Medicine, Department of Obstetrics and Gynecology, Giresun, Turkey.
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Ni L, Sadiq S, Mao Y, Cui Y, Wang W, Liu J. Influence of various tubal surgeries to serum antimullerian hormone level and outcome of the subsequent IVF-ET treatment. Gynecol Endocrinol 2013; 29:345-9. [PMID: 23339657 DOI: 10.3109/09513590.2012.743004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare the influence of various tubal surgeries to ovarian reserve via serum level of antimullerian hormone (AMH) and the subsequent in vitro fertilization and embryo transplantation (IVF-ET) outcome in patients with simple tubal infertility. STUDY DESIGN A prospective cohort study was conducted on 134 IVF cycles undegone by 26 and 34 cases with bilateral and unilateral salpingectomy, respectively, 23 cases with bilateral oviducts interrupted in the proximal and 51 cases with bilateral oviducts obstruction without intervention as controls. RESULTS Serum AMH displayed its great superiority to traditional markers of ovarian reserve in correspondence with antral follicles count and decisive effect for the number of oocytes retrieved after stimulation in each group. No significant differences on ovarian reserve and responsiveness or IVF-ET outcome existed among four groups comparable on essential characteristics, except for numerically higher clinical pregnancy rate and live birth rate after various tubal surgeries versus no intervention for bilateral oviducts obstruction. Especially, bilateral salpingectomy precursed the statistically highest implantation rate (51.0% versus 28.0%, 39.1%, 30.4%) and numerically best IVF outcome. CONCLUSION Tubal surgical procedures have some beneficial effect for improving IVF outcome without significant impact on ovarian reserve or responsiveness. Bilateral salpingectomy appears to be an appropriate procedure before IVF treatment for bilateral salpingitis, especially hydrosalpinx.
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Affiliation(s)
- Lili Ni
- Center of Clinical Reproduction, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Ercan CM, Sakinci M, Coksuer H, Keskin U, Tapan S, Ergun A. Ovarian reserve testing before and after laparoscopic tubal bipolar electrodesiccation and transection. Eur J Obstet Gynecol Reprod Biol 2012; 166:56-60. [PMID: 23036487 DOI: 10.1016/j.ejogrb.2012.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/25/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To find out whether tubal sterilization leads to loss of ovarian reserve, we assessed the hormonal and ultrasonographic parameters of ovarian reserve in women who underwent laparoscopic tubal sterilization by bipolar electrodesiccation and transection. STUDY DESIGN In this preliminary study, laparoscopic tubal sterilization was performed on 49 healthy women who had voluntarily requested elective surgical sterilization. Among the current ovarian reserve indicators, in the early proliferative phases, preoperative (baseline) and postoperative (third month) serum follicle-stimulating hormone (FSH), estradiol (E2), and anti-Mullerian hormone (AMH) levels, ovarian volume, and antral follicle counts (AFCs) were determined. Analysis of these hormonal and ultrasonographic parameters of ovarian reserve preoperatively and postoperatively was the main outcome measure. RESULTS Preoperative and third-month postoperative FSH, LH, E2, and AMH levels did not reveal statistically significant differences (p=0.101, p=0.180, p=0.254, and p=0.079; respectively). The ultrasonographic indicators of ovarian reserve did not change in terms of total ovarian volume and total AFC (p=0.793 and p=0.098, respectively). CONCLUSIONS Short-term follow-up study results revealed a slight but non-significant change in the current ovarian reserve markers, especially in the AMH levels.
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Affiliation(s)
- Cihangir Mutlu Ercan
- Gulhane Military Medical Academy, Obstetrics and Gynecology Department, 06018 Etlik, Ankara, Turkey.
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Gulum M, Yeni E, Sahin MA, Savas M, Ciftci H. Sexual functions and quality of life in women with tubal sterilization. Int J Impot Res 2010; 22:267-71. [PMID: 20574432 DOI: 10.1038/ijir.2010.14] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The aim of this study was to evaluate the sexual functions and quality of life of women who have undergone tubal sterilization after tubal surgery. In all, 90 active premenopausal women, who had undergone tubal sterilization at least 1 year ago and been admitted to four different hospitals, were included in the study group. A total of 100 women at a similar age range, admitted to the same four hospitals for routine health controls, were included in the control group. To obtain sexual function assessments, the patients were asked to fill out Female Sexual Function Index (FSFI) questionnaire. The participants were also asked to fill out Medical Outcomes Study Short Form (SF-36) questionnaire. All values were found to be lower in the tubal sterilization (TS) group and the differences between groups were statistically significant in domain except for pain and lubrication. Similarly, in the analysis of SF-36 scores, there were differences in comparison with the TS group in all domains. In the evaluation of the relationship of FSFI with educational level in the TS group, it was found that, while the educational level increased, all domain scores also increased, and this increase was statistically significant in all domains except pain. The termination of fertility, which is one of the important abilities of women, with tubal sterilization, may be a risk factor for female sexual dysfunction in people with low educational levels.
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Affiliation(s)
- M Gulum
- Department of Urology, Sanliurfa Education and Research Hospital, Sanliurfa, Turkey.
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Raba G. Effect of internal iliac artery ligation on ovarian blood supply and ovarian reserve. Climacteric 2010; 14:54-7. [PMID: 20128664 DOI: 10.3109/13697130903548916] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Internal iliac artery ligation is one of the treatment methods used for obstetric hemorrhage. The long-term effects of that intervention on ovarian function remain unknown. The objective of the study was to evaluate the effect of iliac artery ligation on ovarian blood supply and ovarian reserve. METHODS Six patients who had undergone internal iliac artery ligation were recruited as the study group. Six women of the same age, parity and time after delivery who had not undergone the internal iliac artery ligation procedure served as the control group. Quantitative digital angiography and angio-CT of the ovarian arteries and the ovarian branches of the uterine arteries were carried out from 6 to 26 months after the operation. Blood samples were taken on the 3rd day of the menstrual cycle for subsequent hormone analysis of follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH). RESULTS Following angio-CT, in the study group, reversed blood flow in the ovarian branches of the uterine arteries was observed: contrast medium flowed from the ovarian arteries towards the ovaries and from the ovarian branches of the uterine arteries to the uterine arteries. In the control group, there was no contrast medium flow from the ovaries towards the ovarian branches of the uterine arteries. Quantitative digital angiography of the ovarian arteries showed that, in the study group, the mean ovarian artery diameter was significantly dilated (p < 0.05). In the study group, AMH levels were significantly lower (p < 0.05), while there were no significant differences in FSH levels between groups (p > 0.05). CONCLUSIONS Internal iliac artery ligation in the treatment of obstetric hemorrhage leads to dilation of the ovarian arteries and reversed flow in the ovarian branches of the uterine arteries. These change the blood supply to the ovaries and impair ovarian reserve.
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Affiliation(s)
- G Raba
- Department of Obstetrics and Gynecology, Provincional Hospital in Przemysl, ul. Monte Cassino 18, Przemysl, Poland
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Kelekci S, Yilmaz B, Yakut Y, Yasar L, Savan K, Sonmez S. Hormonal and ovarian stromal blood supply changes after laparoscopic tubal sterilization: a prospective controlled study. Contraception 2005; 73:279-83. [PMID: 16472571 DOI: 10.1016/j.contraception.2005.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Revised: 07/27/2005] [Accepted: 08/02/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study is to determine if the effects of tubal sterilization (TS) by laparoscopy have any risk of a subsequent significant decrease in ovarian reserve and vascular support within the ovary by means of stromal artery Doppler study, and to compare the results with matched paired controls. DESIGN Between February 2002 and January 2005, 148 healthy volunteers were enrolled sequentially, 74 undergoing laparoscopic TS (study group) and 74 age-, parity-, body mass index-matched women were recruited as a control group. The main outcome measurements were blood levels of follicle-stimulating hormone (FSH), luteinizing hormone and E2, ovarian volume, number of antral follicles and Doppler study of ovarian stromal artery pulsatile index (PI) and maximum velocity (Vmax) on the third day of the cycle immediately before, and 1 and 12 months after the surgical intervention. RESULTS There were significant elevations in both serum FSH levels and PI values observed 1 month after TS, compared to the preoperative levels (p < .05), and also when compared to controls. However, there were no significant elevations at 12 months postoperation in both study and control groups. The other outcome measurements did not show any significant differences between the two groups. CONCLUSIONS Tubal sterilization by laparoscopic electrocoagulation does not cause any decrease in ovarian reserve or ovarian stromal blood supply, except an early postoperative increase in FSH and PI.
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Affiliation(s)
- Sefa Kelekci
- Family Planning Unit, Suleymaniye Maternity Hospital, 34340 Istanbul, Turkey.
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