The effect of salpingectomy on the ovarian reserve and ovarian response in ectopic pregnancy: A systematic review and meta-analysis

BACKGROUND: Salpingectomy is routinely performed in ectopic pregnancy (EP). However, the effect of the surgery on the ovarian reserve and ovarian response in EP patients is still uncertain and has not been systematically evaluated. Therefore, we conducted this meta-analysis to provide a comparison of the ovarian reserve and ovarian response between the pre-salpingectomy and post-salpingectomy in EP patients. METHODS: Pubmed, Embase, and Cochrane Library were searched for all relevant articles published up to December 2018. We retrieved the basic information and data of the included studies. The data was analyzed by Review Manager 5.3 software (Cochrane Collaboration, Oxford, UK). RESULTS: A total of 243 articles were extracted from the databases, and 7 studies were included in the meta-analysis. The ovarian reserve including anti-Mullerian hormone (inverse variance [IV] −0.7 [95% confidence interval [CI] −0.63, 0.49]), antral follicle count (IV 1.7 [95% CI −2.02, 5.42]) and basal follicle stimulating hormone (IV 0.02 [95% CI −0.63, 0.68]) was comparable between the pre-salpingectomy group and the post-salpingectomy group. The amount of gonadotropin was significantly higher in the post-salpingectomy group when compared with that in the pre-salpingectomy group (IV −212.65 [95% CI −383.59, −41.71]). There was no significant difference in the left parameters of the ovarian response including the duration of gonadotropin stimulation (IV −0.32 [95% CI −0.76, 0.12]), the estrogen level on the human chorionic gonadotropin triggering day (IV −4.12 [95% CI −236.27, −228.04]) and the number of retrieved oocytes (IV 0.35 [95% CI −0.76, 1.46]) between 2 groups. CONCLUSIONS: The current results suggest that salpingectomy has no negative effect on the ovarian reserve and ovarian response.