Impact of Tubal Ligation During Cesarean Section on Ovarian Reserve and Menstrual Pattern

OBJECTIVE: To evaluate possible adverse effects of tubal ligation during cesarean section on ovarian reserve and menstrual pattern. STUDY DESIGN: Our study was conducted as a prospective cohort study including 163 women who underwent cesarean section with (n=86) or without (n=77) tubal ligation. Ovarian reserve was evaluated by measuring hormone levels including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) anti-Mullerian hormone (AMH), and ultra-sonographic evaluations (antral follicle count and ovarian volume) on the third day of the menstrual cycle and 1 year after the cesarean section. Patients were asked whether there was a change in their menstrual patterns. RESULTS: E2, AMH levels, number of antral follicles, and mean ovarian volumes did not show any significant differences between groups. FSH and LH levels were significantly higher in the tubal ligation group (p =0.02). There was a significant difference between groups in terms of menstrual abnormalities (p=0.01). The highest frequency of the menstrual abnormalities and dysmenorrhea in the tubal ligation group was 66.3% and 47.7%, respectively. A significant difference was found in the presence of dysmenorrhea between groups (p =0.01). CONCLUSION: Tubal ligation during cesarean section can cause increased frequency of menstrual irregularity and dysmenorrhea.