The outcomes of assisted reproductive technology cycles in patients with one or two ovaries

Levi, Rafael; Özçakır, Hasan Tayfun; Alataş, Erkan; Göker, Ege Nazan Tavmergen; Tavmergen, Erol

doi:10.1046/j.1341-8076.2003.00128.x

Cited by 8 publications

(10 citation statements)

References 12 publications

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“…It is of interest that follow-up studies (Gosden et al, 1989) on the ovariectomized mice actually showed that they recruited a larger proportion of the remaining oocyte pool per cycle so that the total number of antral follicles was not reduced. There are conflicting data on this question in humans; several studies have reported a smaller number of retrieved mature follicles after stimulation for IVF by gonadotrophin in age-matched women with one ovary compared to those with two ovaries (Alper et al, 1985;Levitas et al, 2000;Levi et al, 2003); however pregnancy success rates did not differ after IVF.…”

Section: Rates Of Aneuploidy In Women With Reduced Oocyte Pool Sizementioning

confidence: 92%

Biological aging and the etiology of aneuploidy

Warburton¹

2005

Cytogenet Genome Res

104

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A prevalent hypothesis concerning the cause of the rise in aneuploid conceptions with maternal age is that the changes that accompany normal ovarian aging increase the rate of meiotic errors in the oocyte. Biological aging of the ovary is accompanied by a decline in both the total oocyte pool and the number of antral follicles maturing per cycle, as well as changes in the levels of circulating reproductive hormones. The biological aging hypothesis predicts that aneuploidy rates should be higher in women with a prematurely reduced oocyte pool, and that women with trisomic conceptions should show signs of earlier ovarian aging than women of the same chronological age without trisomic conceptions. Comprehensive studies of aneuploidy in groups of women with known causes of premature ovarian failure remain to be done, though anecdotal evidence does suggest increased rates of pregnancy loss and aneuploidy. Smoking, which is a well-documented cause of earlier ovarian aging, is not associated with an increase in aneuploid conceptions. Evidence from women with unilateral ovariectomies is inconsistent. Support for the biological aging hypothesis was provided by one study showing that menopause occurred about a year earlier in women with a trisomic spontaneous abortion compared to women with chromosomally normal conceptions. Associations between high FSH and pregnancies with Down syndrome and chromosomally abnormal spontaneous abortions have also been reported. However, the most direct test of the hypothesis, which compared antral follicle counts and hormonal levels in women with trisomic pregnancies and those with chromosomally normal pregnancies, failed to find a difference in the expected direction. A prospective study of FSH levels in women with subfertility also failed to find an association with the rate of pregnancy loss. The bulk of evidence thus suggests that, if the processes of biological aging are indeed related to aneuploidy, they probably involve factors other than those measured by oocyte or antral follicle pool size and reproductive hormone levels.

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Section: Rates Of Aneuploidy In Women With Reduced Oocyte Pool Sizementioning

confidence: 92%

Biological aging and the etiology of aneuploidy

Warburton¹

2005

Cytogenet Genome Res

104

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“…Fourteen were rejected as duplicate publications and another 765 studies did not investigate the effect of UO on ovarian reserve and were therefore excluded. Thirty‐seven studies were reviewed in full and assessed for eligibility . Twelve studies were then excluded: nine in non‐ART setting, two involving cancer patients and one exclusively considering women with polycystic ovaries .…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies were then excluded: nine in non‐ART setting, two involving cancer patients and one exclusively considering women with polycystic ovaries . In all, 25 studies were eligible for qualitative synthesis and 21 for quantitative synthesis . Quality assessment of the qualified studies for meta‐analysis employing the Newcastle‐Ottawa scale is provided in Appendix S2.…”

Section: Resultsmentioning

confidence: 99%

“…Collectively, available studies included 673 and 9059 women undergoing 1045 and 18 172 IVF‐ET cycles in the study group and control groups, respectively. Six of these studies included ORTs assessment (Table S1) and all 21 studies reported some measures of ovarian response and IVF‐ET outcome …”

Section: Resultsmentioning

confidence: 99%

“…Five of the 21 studies eligible for meta‐analysis included data regarding basal serum FSH level before starting COH, one employed AFC, and one AMH for ovarian reserve assessment. The five studies examining basal FSH included 291 IVF‐ET cycles in patients with a single ovary compared with 1320 cycles in patients with two ovaries (Table S4).…”

Section: Resultsmentioning

confidence: 99%

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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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Women with one ovary in assisted reproduction technologies: a review of the literature

Βouchlariotou¹,

Tsikouras

Rösing³

et al. 2012

Arch Gynecol Obstet

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The outcomes of assisted reproductive technology cycles in patients with one or two ovaries

Abstract: The potential for success after in vitro fertilization is not impaired in women with one ovary.

Cited by 8 publications

References 12 publications

Biological aging and the etiology of aneuploidy

Biological aging and the etiology of aneuploidy

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

Women with one ovary in assisted reproduction technologies: a review of the literature

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