Unilateral oophorectomy results in compensatory follicular recruitment in the remaining ovary at time of ovarian stimulation for in vitro fertilization

Khan, Zaraq; Gada, R.; Tabbaa, Zaid M.; Laughlin-Tommaso, Shannon K.; Jensen, Jani R.; Coddington, Charles C.; Stewart, Elizabeth A.

doi:10.1016/j.fertnstert.2013.11.019

Cited by 32 publications

(29 citation statements)

References 28 publications

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“…In humans, Lass [13] reported that women with a single ovary responded less well to ovarian stimulation than women with both ovaries in terms of the number of follicles, concentrations of estradiol and number of oocytes retrieved but do not, in general, have reduced fertility potential to conceive. In agreement with this, Khan et al [14] demonstrated that women with unilateral ovary had higher antral follicle count at baseline when compared with the ipsilateral ovary in referent women. The women with unilateral ovary had more follicles and oocytes when they underwent hormonal stimulation than the ipsilateral ovary of women with both ovaries.…”

Section: Introductionsupporting

confidence: 55%

“…This appears to suggest compensatory follicular recruitment of the remaining ovary. In these women unilateral oophorectomy results in compensatory follicular recruitment in the remaining ovary at the time of ovarian stimulation for in vitro fertilization [14]. By contrast, other clinical studies suggest that women with a single ovary may have a decreased ovarian reserve, which may shorten the reproductive life span and increase the risk of an early menopause [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Unilateral adnexal agenesis and dermoid cyst: fertility implications

Fruzzetti

Bucci

Perini

et al. 2015

Gynecological Endocrinology

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We report the loss of potential fertility in a 23-year-old nulliparous woman who attended the outpatient gynaecological endocrinology clinic for amenorrhea and hot flushes started after a laparoscopic surgery for dermoid cyst. During surgery an unilateral ovarian and fallopian tube agenesis were found. The hormonal evaluation was performed. The results evidenced high plasma levels of LH and FSH. Their values were 56.6 and 121.3 mUI/ml, respectively. The concentrations of plasma E2 were < 20 pg/ml and of AMH were <0.08 ng/ml. Genetic analysis showed normal karyotype (46, XX). We think that if an embryological defect is suspected, an appropriate counselling about fertility preservation along with the assessment of hormonal levels before ovarian surgery should be recommended to all women in the reproductive age in order to offer future reproductive chances.

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Section: Introductionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Unilateral adnexal agenesis and dermoid cyst: fertility implications

Fruzzetti

Bucci

Perini

et al. 2015

Gynecological Endocrinology

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“…Conversely, although UO crudely signifies acute reduction of ovarian reserve by half, two high‐quality studies have shown that age at menopause is reduced only by 1.2–1.4 years, suggesting compensatory mechanisms for ovarian ageing . Two recent reports in the ART setting support this view, showing that the remaining ovary appears to compensate in follicular yield following after UO in women . The nature and magnitude of reproductive ageing mechanisms of compensation, by intra‐, inter, or extra‐ovarian signalling, are still to be determined …”

Section: Discussionmentioning

confidence: 99%

“…39,40 Two recent reports in the ART setting support this view, showing that the remaining ovary appears to compensate in follicular yield following after UO in women. 31,32 The nature and magnitude of reproductive ageing mechanisms of compensation, by intra-, inter, or extra-ovarian signalling, are still to be determined. 32…”

Section: Discussionmentioning

confidence: 99%

The impact of unilateral oophorectomy on ovarian reserve in assisted reproduction: a systematic review and meta‐analysis

Younis

Naoum

Salem

et al. 2017

BJOG

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Background Women following unilateral oophorectomy (UO) are occasionally encountered during assisted reproduction treatment.Objective To explore the impact of UO on ovarian reserve in assisted reproduction.Search strategy An electronic database search was performed using PubMed, EBSCO, ISI, Trip, ClinicalTrial.gov and the Cochrane library followed by a manual search to identify published research between January 1978 and December 2015.Selection criteria Controlled studies that compared infertile women following UO undergoing IVF-ET treatment with women with two intact ovaries.Data collection and analysis Two reviewers independently extracted the data concerning the impact of UO on ovarian reserve tests, ovarian response to controlled ovarian hyperstimulation and clinical pregnancy rate. Meta-analysis was performed using these measures.Main results Twenty-one studies were eligible for quantitative analysis. They included 1045 and 18 172 IVF cycles in women with one and two intact ovaries, respectively. Basal FSH weighted mean difference (WMD) was significant (2.01 IU/l; 95% CI: 0.24-3.79, P = 0.026). Similarly, the WMD of serum E 2 level on the day of hCG administration was significant (WMD: À431 pg/ml; 95% CI: À616 to À246, P < 0.001). However, the weighted overall odds ratio (OR) of clinical pregnancy between women with a single ovary and women with two ovaries was comparable (overall OR: 0.76; 95% CI: 0.57-1.00, P = 0.054). All eligible studies were retrospectively conducted and the heterogeneity among ovarian response measures was high.Conclusions Available pooled data supports an adverse effect of UO on ovarian reserve involving the quantity but not the quality of the ovarian pool.Keywords Assisted reproduction, in vitro fertilisation, metaanalysis, ovarian reserve, systematic review, unilateral oophorectomy.Tweetable abstract Review finds women with one ovary removed have less IVF capacity but the same pregnancy rate as women with two ovaries.Please cite this paper as: Younis JS, Naoum I, Salem N, Perlitz Y, Izhaki I. The impact of unilateral oophorectomy on ovarian reserve in assisted reproduction: a systematic review and meta-analysis. BJOG 2018;125:26-35.

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“…Additionally, while data on the long-term fertility implications of having one ovary as an otherwise healthy woman without cancer are scarce, a potentially interesting area for future study is raised by our results [16]. Recent work by Bellati et al and others suggests that healthy women who undergo unilateral oophorectomy have similar post-operative fertility outcomes to those who do not [17][18][19]. As rates of infertility with unilateral oophorectomy after cancer appear higher than in the general population, one wonders whether they may also be higher than healthy women with one ovary.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 93%