Fertility and sterility · 2016
Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycles?
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Yoon Sang-Hee, Lee Ji Young, Kim Soo-Nyung, Chung Hye Won, Park So Yun, Lee Chulmin
Аннотация
OBJECTIVE: To investigate the impact of salpingectomy in patients with IVF treatment on ovarian response.
DESIGN: Meta-analysis.
SETTING: Not applicable.
PATIENT(S): Patients under treatment for infertility, during the cycles before and after treatment by salpingectomy for hydrosalpinx or ectopic pregnancy.
INTERVENTION(S): PubMed, MEDLINE, EMBASE databases, and CENTRAL in Cochrane Library up to July 2015. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. The subgroup analysis was planned a priori before data were collected and analyzed.
MAIN OUTCOME MEASURE(S): The amount of gonadotropin administered, the peak E2 level, the number of oocytes retrieved, and the number of pregnancies.
RESULT(S): After the final screening, 12 of the studies were retrospective and six were prospective. In this meta-analysis, 1,482 patients were enrolled, including a total of 657 patients with salpingectomy and 825 without salpingectomy. The comparisons before and after salpingectomy of the peak E2 level (standardized mean difference [SMD] = -0.182; 95% confidence interval [CI], -0.166, 0.101; I2, 85.45%), the total gonadotropin dose used for stimulation (SMD = 0.127; 95% CI, -0.054 0.308; I2, 84.49%), and number of oocytes retrieved (SMD = -0.060; 95% CI, -0.189, 0.070; I2, 63.93%) did not reveal any significant differences. The number of pregnancies before and after salpingectomy did not differ significantly (odds ratio [OR] = 1.180; 95% CI, 0.854, 1.630; I2, 34.01%).
CONCLUSION(S): Salpingectomy in infertile patients does not have any negative effect on their subsequent fertility treatment, but further studies should be performed before this result can be considered definitive.
DESIGN: Meta-analysis.
SETTING: Not applicable.
PATIENT(S): Patients under treatment for infertility, during the cycles before and after treatment by salpingectomy for hydrosalpinx or ectopic pregnancy.
INTERVENTION(S): PubMed, MEDLINE, EMBASE databases, and CENTRAL in Cochrane Library up to July 2015. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates. The subgroup analysis was planned a priori before data were collected and analyzed.
MAIN OUTCOME MEASURE(S): The amount of gonadotropin administered, the peak E2 level, the number of oocytes retrieved, and the number of pregnancies.
RESULT(S): After the final screening, 12 of the studies were retrospective and six were prospective. In this meta-analysis, 1,482 patients were enrolled, including a total of 657 patients with salpingectomy and 825 without salpingectomy. The comparisons before and after salpingectomy of the peak E2 level (standardized mean difference [SMD] = -0.182; 95% confidence interval [CI], -0.166, 0.101; I2, 85.45%), the total gonadotropin dose used for stimulation (SMD = 0.127; 95% CI, -0.054 0.308; I2, 84.49%), and number of oocytes retrieved (SMD = -0.060; 95% CI, -0.189, 0.070; I2, 63.93%) did not reveal any significant differences. The number of pregnancies before and after salpingectomy did not differ significantly (odds ratio [OR] = 1.180; 95% CI, 0.854, 1.630; I2, 34.01%).
CONCLUSION(S): Salpingectomy in infertile patients does not have any negative effect on their subsequent fertility treatment, but further studies should be performed before this result can be considered definitive.