Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation

Abstract

Introduction: Ovarian reserve is a major prognosic factor for Medical Assisted Procreation. Tubal surgery, realised close to mesosalpinx and ovarian vascularization, could impare ovarian function. However, salpingectomy is currently used to treat ectopic pregnancies or hydrosalpinx before IVF attempt. Disponible studies on this subject are unclear. The aim of this study is to evaluate the impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF attempt. Material and methods: It was a single center comparative study. Included patients were the one receiving oocyte puncture for IVF attempt, with a history of unilateral tubal surgery: salpingectomy for ectopic pregnancy. We conducted a case-control study, comparing the sonographic parameters of the surgery ovary (case) to those of the safe ovary (control) during the first IVF attempt after salpingectomy. The ovarian sonographic response was evaluated according to the follicular antral count on day 3 and the sonographic follicular count on trigger day. Results: 55 patients were included. There was no significant difference in the number of recruited follicles on the operated side versus control side (p = 0.85 for >14 mm follicles, p = 0,46 for 10 to 14 mm, p = 0,52 for total amount of recruited follicles). There was no significant difference for the follicular antral count neither (p = 0.79). Discussion: In our population, there was no significant difference in the sonographic ovarian response to IVF stimulation between the ovary on the operated side and the control ovary among patients treated by unilateral salpingectomy for ectopic pregnancy.

Methotrexate versus Methotrexate Combined with Letrazole for Management of Undisturbed Ectopic Pregnancy

“…In Mitwally et al (12) , Frates et al (13) , and Gay et al (14) the average platelet count for MTX was 251.5 on the first day of treatment and reached 162 × 103 on day seven; for letrozole, it was 214.9 on the first day of treatment and reached 213.9 × 103 on day seven. On the day of therapy, for MTX, the average AST level was 19.8 and it rose to 44.1 (U/L).…”

The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)

“…Moreover, both PID and salpingectomy, especially bilateral, lead to infertility, thus increasing the demand for in vitro fertilization (IVF) in Kazakhstan [ 38 , 39 ]. Although some studies have found that unilateral salpingectomy for ectopic pregnancy by itself does not impair the ovarian reserve and response during IVF stimulation [ 40 , 41 ], contradictory results were reported for bilateral surgery [ 27 ]. Moreover, psychological stress related to the loss of tubes and subsequent sterility might contribute to the psychological distress existing in patients undergoing IVF procedures [ 38 , 42 ].…”

Pregnancy outcomes following in vitro fertilization treatment in women with previous recurrent ectopic pregnancy

“…This finding could be explained by the effect of tubal surgery for EP on ovarian reserve and ovarian response. Because ovarian vascularization is close to the fallopian tube and mesosalpinx, tubal surgery may impair ovarian vascularization and function [ 33 , 34 ].…”