Ovarian reserve after salpingectomy: a systematic review and meta‐analysis

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-M€ ullerian 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% CI. Two groups of studies were analyzed separately: 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, À0.10 ng/mL; 95% CI À0.19 to 0.00, I 2 = 0%). Similarly, meta-analysis of group 2 showed no statistically significant difference in serum AMH concentration between salpingectomy group and controls (WMD, À0.11 ng/ mL; 95% CI À0.37 to 0.14, I 2 = 77%). Subgroup analyses based on laterality of surgery, type of AMH kit and participants' age (<40 years) 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.

Ovarian Cancer Prevention and Screening

“…92,93 Such efforts may be cost-effective and acceptable alternatives for women unwilling to undergo risk-reducing bilateral salpingo-oophorectomy. 92,94,95 A recent meta-analysis has indicated that salpingectomy does not impact ovarian reserve in the short-term, 96 however longer-term effects remain unclear and need to be assessed. Radical removal of the fimbrial end of the tube as a way to reduce risk in these women is being trialed in a study in France, 97 while in the United States, a clinical trial of bilateral salpingectomy with delayed oophorectomy in BRCA mutation carriers is currently underway.…”

Clinical application of serum anti‐Müllerian hormone as an ovarian reserve marker: A review of recent studies

“…A systematic review and meta‐analysis of six longitudinal studies and two cross‐sectional studies was published in 2017 . Either meta‐analysis comparing pre‐ and postoperative serum AMH or comparing the salpingectomy and control groups showed no significant differences in serum AMH levels.…”

Knowledge of Iatrogenic Premature Ovarian Insufficiency Among Chinese Obstetricians and Gynecologists: A National Questionnaire Survey

“…Our survey demonstrated that 33.5% of respondents still worried about UAE leading to POI, especially in tertiary hospitals where UAE procedures are completed more frequently. BS and BTL are less likely to induce POI, as they may have no short-term signi cant effects on ovarian function indicators [44][45][46]. However, their long-term effect on fertility outcomes remains uncertain [44,47].…”