Opportunistic Salpingectomy

Ovarian cancer is a deadly disease that is hard to detect early and difficult to treat. Research shows that most ovarian cancers actually start in the fallopian tubes, not the ovaries. Removing the fallopian tubes (a procedure called salpingectomy) can lower the risk of ovarian cancer by about 80%. This procedure has no added risk to the patient, but does lead to sterilization and thus it is only offered to individuals who have completed child-bearing. Adding salpingectomy to another surgery that a patient is undergoing is called opportunistic salpingectomy and is already standard of practice in many gynecologic surgeries, such as hysterectomy. However, it is not yet commonly offered during weight-loss (bariatric) surgery, even though many patients having this surgery could benefit. This study will test whether it is practical and safe to offer fallopian tube removal during bariatric surgery at three hospitals in Canada. Patients who are eligible and interested will be invited to have their fallopian tubes removed at the same time as their planned weight-loss surgery. The research team will track whether the procedure can be completed successfully, whether there are any added complications, and how much extra time or resources are needed. The goal is to help make this cancer-prevention option available to more people.

The goal of this clinical trial is to find out whether removing the fallopian tubes at the time of hysterectomy leads to an earlier menopause. The study includes women under 55 years of age who previously underwent hysterectomy as participants in the HOPPSA trial, where they were randomly assigned to either removal of the fallopian tubes or no removal. The main question is: • Does removing the fallopian tubes at the time of hysterectomy lead to an earlier menopause? Researchers will compare women who had their fallopian tubes removed during hysterectomy with women who had hysterectomy alone to see whether menopause occurs earlier after tube removal. Age at menopause will be estimated by measuring follicle-stimulating hormone (FSH) in small blood samples collected on a paper card. Participants will: * Collect 4-5 drops of blood using a finger prick * Place the drops on a paper card and mail it to the researchers * Complete an online questionnaire These steps will be done twice, one year apart.