Human endometrial perfusion after tubal occlusion

Abstract

We examined variations in human endometrial microvascular perfusion across one menstrual cycle in women who had undergone tubal ligation and did not report unusual menstruation. Endometrial red blood cell flux was monitored by laser Doppler fluxmetry via a fibreoptic probe atraumatically inserted transvaginally into the uterus of each of 13 conscious volunteers. The observations obtained have been compared with those previously reported from a matched control group of women [B.J. Gannon et al., Hum. Reprod., 12, 132-139 (1997)]. Women who had undergone tubal occlusion for sterilization exhibited greater endometrial perfusion during menstruation (cycle days 0-5), at the time of ovulation (cycle days 13-16) and in the late secretory phase (cycle days 23-28) than occurred in controls. In addition, vasomotion in the study group was lower than that in controls in the early and late secretory phase (cycle days 17-22 and 23-28). Tubal occlusion appeared to alter endometrial perfusion. It is possible that the reported menstrual changes in women following tubal ligation are a consequence of altered endometrial perfusion; a possible causative relationship is discussed.

The effect of tubal sterilization with the Pomeroy technique and bipolar electrocauterization on the ovarian reserve and serum anti-Müllerian hormone levels in a rat model

“…Verco et al [16] evaluated human endometrial microvascular perfusion in women who have undergone TL. They reported that menstrual changes in women after TL were a result of altered endometrial perfusion.…”

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“…This is in contrast to the study by Steer et al (11), who found an increased PI value in women with tubal infertility when compared with that of normal women. However, in a subsequent study (12) the investigators found that women who had tubal occlusion exhibited greater endometrial perfusion than the controls.…”

“…The more disruptive the tubal blockage, the more intensely vascular anastomosis might be established as a result of the healing process. Furthermore, the counter-current exchange of biological factors may be disturbed either because these factors did not enter the venous drainage or because the arterial supply is unable to deliver these factors to their target organs (12).…”

Histopathological changes in ovary and endometrium after tubal ligation: a rat model

“…The other study (8) showed no significant differences between Pomeroy's technique and laparoscopic tubal rings in terms of post‐sterilization incidence of luteal defects. Verco et al (28) examined variations in human endometrial microvascular perfusion across one menstrual cycle in women who had undergone tubal ligation and reported that the menstrual changes in women after tubal ligation are a consequence of altered endometrial perfusion.…”