Effect of salpingectomy on ovarian reserve: A systematic review and meta‐analysis

Abstract

Aim To determine the effect of salpingectomy on ovarian reserve. Methods PubMed, EMBASE, Web of Science, Dynamed plus, and Cochrane Controlled Trials Register databases were searched from their inception to December 2020 to identify relevant studies, including cross‐sectional studies, retrospective studies, and randomized controlled trials. Studies that compared anti‐Müllerian hormone (AMH) levels and/or antral follicle count (AFC) between the control and salpingectomy groups or before and after surgery were included. Results Twenty‐one articles were included in the systematic review. Meta‐analyses were performed on 16 studies in which data were presented as mean ± SD values. A meta‐analysis comparing AMH levels before and after surgery in the same patients showed no significant decrease in all cases, irrespective of whether it was unilateral or bilateral salpingectomy. There was no significant decrease in the AFC in the meta‐analysis comparing levels before and after bilateral salpingectomy, either. In contrast, in the case–controlled study the salpingectomy group had significantly lower levels of AMH in all meta‐analyses of unilateral and bilateral surgery (mean difference: −0.31, 95% confidence interval [CI]: −0.55, −0.07), only unilateral cases (mean difference: −0.28, 95% CI: −0.50, −0.06), and only bilateral cases (mean difference: −0.71, 95% CI: −1.19, −0.23). The salpingectomy group that included unilateral and bilateral cases had significantly lower AFC compared with no‐surgery controls (mean difference: −1.31, 95% CI: −2.13, −0.48). Conclusion Although not conclusive, it does appear that patients who underwent salpingectomy (either unilateral or bilateral) have a decreased ovarian reserve.

The Effect of Salpingectomy on Ovarian Reserve Using Two Different Electrosurgical Instruments: Ultrasonic Shears Versus Bipolar Electrocautery

“…AFC, on the other hand, showed a statistically significant decline in the bipolar electrocautery group compared to the ultrasonic shear group measured during the three-month postoperative period (p=0.0002). The ultrasonic shear, being equipment based on high-frequency ultrasonic energy, has been proven to cause lesser lateral dissipation of energy and, thereby, a lesser degree of damage to non-target organs when compared to its electrosurgical counterparts like electrocautery [13]. This property makes ultrasonic shear a safer alternative, as indicated by the findings in our study.…”

Isolated fallopian tube torsion with preservation of ipsilateral ovary. A case report

“…Recognition of this condition and timely management increase the likelihood of tubal-sparing surgery and preservation of fertility [ 7 ].…”

Ovarian Follicular Response Is Altered by Salpingectomy in Assisted Reproductive Technology: A Pre- and Postoperative Case–Control Study

“…Over the past thirty years, the impact of this surgery has been assessed by several parameters, including antral follicle count (AFC), hormone levels (follicle-stimulating hormone (FSH) and anti-mullerian hormone (AMH)), or gonadotropins administration dose, stimulation cycle length, oocyte retrieval, and pregnancy rates, as highlighted by these eight systematic reviews and meta-analyses [15][16][17][18][19][20][21][22]. Although its impact has been demonstrated in animal studies [23,24], results in human remain controversial due to several biases, as inter-individual and intra-individual-inter-cycle-variabilities in ovarian responses [25].…”