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Ovarian reserve after salpingectomy: a systematic review and meta-analysis
2017-03-23

Acta Obstetricia et Gynecologica Scandinavica
Accepted manuscript online: 17 MAR 2017
Doi: 10.1111/aogs.13133

Keywords
salpingectomy; ovarian reserve; anti-Müllerian hormone; ovarian function; laparoscopy

Abstract

Introduction

Although there has been a growing concern over the possible damaging effect of salpingectomy on ovarian reserve, this issue remains uncertain. The purpose of this meta-analysis was to test the hypothesis that salpingectomy may compromise ovarian reserve.

Material and methods

A detailed search was conducted using MEDLINE, Embase, Dynamed Plus, ScienceDirect, TRIP database and the Cochrane Library from January 2000 to November 2016. All cohort, cross-sectional and randomized controlled studies investigating changes in circulating anti-Müllerian hormone (AMH) after salpingectomy were considered. Thirty-seven studies were identified, of which eight were eligible. Data were extracted and entered into RevMan software for calculation of the weighted mean difference (WMD) and 95% confidence interval (CI). Two groups of studies were analyzed separately including group 1 (six studies, n=464) comparing data before and after salpingectomy and group 2 (two studies) comparing data in women who have undergone salpingectomy (n=169) vs. healthy controls (n=154)

Results

Pooled results of group 1 studies showed no statistically significant change in serum AMH concentration after salpingectomy (WMD, -0.10ng/ml; 95% CI; -0.19 – 0.00, I2=0%). Similarly, meta-analysis of group 2 showed no statistically significant difference in serum AMH concentration between salpingectomy group and controls (WMD, -0.11ng/ml; 95% CI; -0.37 – 0.14, I2=77%). Subgroup analyses based on laterality of surgery, type of AMH kit and participants’ age (<40) still showed no statistically significant changes in circulating AMH

Conclusion

Salpingectomy does not seem to compromise ovarian reserve in the short-term. However, the long-term effect of salpingectomy on ovarian reserve remains uncertain.

資料來源 : Obstetrics & Gynaecology



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