Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycles?

Abstract

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 E-2 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 E-2 level (standardized mean difference [SMD] = -0.182; 95% confidence interval [CI], -0.166, 0.101; I-2, 85.45%), the total gonadotropin dose used for stimulation (SMD = 0.127; 95% CI, -0.054 0.308; I-2, 84.49%), and number of oocytes retrieved (SMD = -0.060; 95% CI, -.189, 0.070; I-2, 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; I-2, 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. (C) 2016 by American Society for Reproductive Medicine.