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

Journal

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH
Volume 48, Issue 7, Pages 1513-1522

Publisher

WILEY
DOI: 10.1111/jog.15316

Keywords

AFC; AMH; hydrosalpinx; ovarian reserve; salpingectomy

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The study suggests that salpingectomy (both unilateral and bilateral) may lead to a decrease in ovarian reserve.
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-Mullerian 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.

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