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 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.

Keywords: Salpingectomy; in vitro fertilization; ovarian response.