Low-pressure pneumoperitoneum reduces influence on ovarian hormones in infertile women: a randomised trial.

BACKGROUND

Pneumoperitoneum is commonly used in laparoscopic gynecological surgery. This study investigated the effect of carbon dioxide (CO2) pneumoperitoneum pressure on ovarian function following laparoscopic surgery in infertile women.

METHODS

A total of 424 infertile patients were allocated to 4 groups according to different CO2 pneumoperitoneum pressures undergo laparoscopic surgery. Complications and the levels of serum estradiol (E2), progesterone (P), luteinizing hormone (LH), testosterone (T), and follicle-stimulating hormone (FSH) were observed and measured. Ovarian function was also evaluated by using mean ovarian volume, maximal ovarian volume, mean follicle number, and maximal follicle diameter.

RESULTS

A total of 118 cases were included and their data were retrospectively analyzed. Complications were observed in all groups with the highest incidence in participants receiving 15-16 mmHg CO2. Pneumoperitoneum increased the levels of E2, FSH, and LH (P<0.05) with increasing pressure, especially in the first menstrual period after surgery, and these levels had returned to normal by the third menstruation; the levels of P and T were not affected.The MOV, MFD and MFN remained unchanged after surgery in four groups, and the menstrual cycle after surgery at 1 month in group D delayed (P<0.05).

CONCLUSIONS

The use of CO2 for pneumoperitoneum affects the levels of E2, LH, and FSH during the first menstruation after laparoscopic surgery in a pressure-dependent manner and the impact vanishes by the third menstruation.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100046221.