Journal of minimally invasive gynecology · 2026
When Performing vNOTES Salpingectomy, Are We Damaging the Ovarian Reserve? Results From a Randomized, Controlled Trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Yıldız Elif, Coşkun Enes Serhat, Timur Gözde Yıldırım, Bacak Havva Betül, Acıyiyen Yağmur, Terkan Hayat, Bilici Sema Rumeysa, Ersoy Deniz, Aldanmaz Barışcan, Salman Süleyman, Çelikoğlu Ecenur
Аннотация
STUDY OBJECTIVE: To compare the effects of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy (CL) on ovarian reserve in women undergoing opportunistic bilateral salpingectomy (BS) for permanent sterilization.
DESIGN: Prospective randomized controlled trial.
SETTING: Tertiary care university hospital.
PATIENTS: Eighty-one women seeking permanent surgical sterilization were included; 35 underwent vNOTES salpingectomy and 46 underwent laparoscopic salpingectomy.
INTERVENTIONS: All participants underwent BS using either the vNOTES approach or conventional laparoscopy.
MEASUREMENTS AND MAIN RESULTS: Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) measured preoperatively and at 3 months postoperatively. The 2 groups were comparable in terms of demographic characteristics. No statistically significant differences were observed between the vNOTES and CL groups regarding preoperative or postoperative 3-month AMH levels (p > .05), and repeated-measures ANOVA revealed no significant time × group interaction (p = .222). AFC values were also comparable between groups. Postoperative pain scores at 6 hours were significantly lower in the vNOTES group compared with the CL group (p < .001).
CONCLUSION: vNOTES salpingectomy did not adversely affect ovarian reserve at 3 months compared with conventional laparoscopy, as assessed by AMH and AFC. Early postoperative pain scores were lower in the vNOTES group; however, pain was a secondary outcome. Larger studies with longer follow-up are warranted.
CLINICALTRIALS: GOV: NCT07177144, Date: 15/06/2025.
DESIGN: Prospective randomized controlled trial.
SETTING: Tertiary care university hospital.
PATIENTS: Eighty-one women seeking permanent surgical sterilization were included; 35 underwent vNOTES salpingectomy and 46 underwent laparoscopic salpingectomy.
INTERVENTIONS: All participants underwent BS using either the vNOTES approach or conventional laparoscopy.
MEASUREMENTS AND MAIN RESULTS: Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC) measured preoperatively and at 3 months postoperatively. The 2 groups were comparable in terms of demographic characteristics. No statistically significant differences were observed between the vNOTES and CL groups regarding preoperative or postoperative 3-month AMH levels (p > .05), and repeated-measures ANOVA revealed no significant time × group interaction (p = .222). AFC values were also comparable between groups. Postoperative pain scores at 6 hours were significantly lower in the vNOTES group compared with the CL group (p < .001).
CONCLUSION: vNOTES salpingectomy did not adversely affect ovarian reserve at 3 months compared with conventional laparoscopy, as assessed by AMH and AFC. Early postoperative pain scores were lower in the vNOTES group; however, pain was a secondary outcome. Larger studies with longer follow-up are warranted.
CLINICALTRIALS: GOV: NCT07177144, Date: 15/06/2025.