Review ArticleThe Effect of Salpingectomy on Ovarian Function
Section snippets
Methods
A search was performed in PubMed, the Cochrane Library, and Ovid MEDLINE. Phrases used in the search were suited for each individual database and included “salpingectomy AND ovarian reserve,” “salpingectomy AND AMH,” “salpingectomy AND FSH,” “salpingectomy AND antral follicle count,” “salpingectomy AND fertility,” “salpingectomy AND IVF,” “salpingectomy AND ovarian hyperstimulation,” “salpingectomy AND oocyte,” “salpingectomy AND tubal occlusion,” and “salpingectomy AND menopause.” Our search
Results
The systematic literature search yielded 249 articles. Only 48 of these articles met the inclusion criteria (Fig). These articles are outlined by author, study type, indications, outcomes, strengths, weaknesses, and findings (Table 1, Table 2, Table 3).
Nearly all of the salpingectomies were performed laparoscopically. Over a quarter of the articles were randomized controlled trials. The remainder were retrospective and prospective cohort studies. Two case-control studies were included with 1
Conclusions
Overall, it appears that salpingectomy is unlikely to have a substantial adverse impact on ovarian reserve. The majority of existing studies have reported reassuring findings, and no clear evidence exists to recommend against salpingectomy when tubal surgery is otherwise indicated. Still, reports of alterations in FSH, AMH, AFC, or the ovarian pulsatility index cannot be completely discounted.
Of note, the indication for salpingectomy in the majority of the studies noting a detrimental effect on
References (60)
- et al.
The role of the fallopian tube in the origin of ovarian cancer
Am J Obstet Gynecol
(2013) - et al.
Physician opinions regarding elective bilateral salpingectomy with hysterectomy and for sterilization
J Minim Invasive Gynecol
(2013) - et al.
Does salpingectomy affect the ipsilateral ovarian response to gonadotropin during in vitro fertilization-embryo transfer cycles?
Fertil Steril
(2011) - et al.
Wide excision of soft tissues adjacent to the ovary and fallopian tube does not impair the ovarian reserve in women undergoing prophylactic bilateral salpingectomy: results from a randomized, controlled trial
Fertil Steril
(2015) - et al.
Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial
Fertil Steril
(2013) - et al.
3 to 5 years later: Long-term effects of prophylactic bilateral salpingectomy on ovarian function
J Minim Invasive Gynecol
(2017) - et al.
The impact of salpingectomy and single-dose systemic methotrexate treatments on ovarian reserve in ectopic pregnancy
Eur J Obstet Gynecol Reprod Biol
(2016) - et al.
A retrospective analysis of the effect of salpingectomy on serum antimullerian hormone level and ovarian reserve
Am J Obstet Gynecol
(2015) - et al.
Effect of salpingectomy on ovarian response to superovulation in an in vitro fertilization-embryo transfer program
Fertil Steril
(1998) - et al.
Improved fertility following conservative surgical treatment of ectopic pregnancy
BJOG
(2003)
Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial
Lancet
Surgery for ectopic pregnancy: making the right choice
Lancet
Hydrosalpinx and infertility: what about conservative surgical management?
Eur J Obstet Gynecol Reprod Biol
Does previous salpingectomy improve implantation and pregnancy rates in patients with severe tubal factor infertility who are undergoing in vitro fertilization? A pilot prospective randomized study
Fertil Steril
Effects of salpingectomy on ovarian response in controlled ovarian hyperstimulation for in vitro fertilization: a reappraisal
Fertil Steril
Ovarian response to gonadotropins in patients with tubal factor infertility: salpingectomy versus nonsalpingectomy
J Minim Invasive Gynecol
Ovarian response to gonadotropins after laparoscopic salpingectomy for ectopic pregnancy
Int J Gynaecol Obstet
Effect of methotrexate or salpingectomy for ectopic pregnancy on subsequent in vitro fertilization-embryo transfer outcomes
J Minim Invasive Gynecol
Ovarian response and in vitro fertilization outcomes after salpingectomy: does salpingectomy indication matter?
J Minim Invasive Gynecol
Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization-embryo transfer
Fertil Steril
Laparoscopic management of hydrosalpinges before in vitro fertilization–embryo transfer: salpingectomy versus proximal tubal occlusion
Fertil Steril
Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges
Fertil Steril
Comprehensive Gynecology
The post-reproductive fallopian tube: better removed?
Hum Reprod
The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory
Am J Surg Pathol
Cyclin E1 deregulation occurs early in secretory cell transformation to promote formation of fallopian tube-derived high-grade serous ovarian cancers
Cancer Res
Atlas of Pelvic Anatomy and Gynecologic Surgery
Testing and interpreting measures of ovarian reserve: a committee opinion. Practice guideline. American Society of Reproductive Medicine
Fertil Steril
Effect of salpingectomy, ovarian cystectomy and unilateral salpingo-oopherectomy on ovarian reserve
Gynecol Surg
The effect of surgery for endometrioma on ovarian reserve evaluated by antral follicle count: a systematic review and meta-analysis
Hum Reprod
Cited by (35)
The effect of opportunistic salpingectomy for primary prevention of ovarian cancer on ovarian reserve: a systematic review and meta-analysis
2022, MaturitasCitation Excerpt :Ovarian reserve can be useful as predictor for age at menopause, since ovarian reserve will decline as women mature [49]. However, given that the damage may have only a subtle impact, a reduction in ovarian perfusion and thereby decrease in steroid production and follicular development could occur without short-term reflection in diminished ovarian reserve [50]. As the risk of all-cause mortality increases with each year of earlier menopause [51], investigating the actual effect of OS on the menopausal age is vital.
Impact of salpingectomy for ectopic pregnancy on the ovarian response during IVF stimulation
2019, Journal of Gynecology Obstetrics and Human ReproductionCitation Excerpt :In our study, the inclusion of patients who have all been treated by salpingectomy for EP permitted us to obtain a uniform population and a close surgical technique. Salpingectomy is probably the most invasive technique, in an emergency and tubal suffering context, which would have the most important impact on the ovarian function, as Kotlyan's study suggests it does [9]. Our population was quite important (55 patients) and is the second population with comparable patients available in the literature to this day, after Xi's study (76 cases) [11].
N <sup>o</sup> 377- Indications gynécologiques bénignes de l'hystérectomie
2019, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :À l'heure actuelle, il n'y a pas de données probantes solides qui puissent orienter l'attitude chirurgicale par rapport à la voûte vaginale pour prévenir un prolapsus subséquent de la voûte chez les patientes sans POP. Des études ont démontré que l'inclusion des ligaments cardinaux et utéro-sacrés dans les marges du dôme vaginal lors de l'HAT et de l'HV100-112 peut aider à minimiser le risque de prolapsus subséquent de la voûte après l'hystérectomie. L'incidence du prolapsus de la voûte vaginale après une HL ou une HR n'est pas bien établie.
No. 377-Hysterectomy for Benign Gynaecologic Indications
2019, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :However, there is a slight increase in procedural time when bilateral salpingectomy is performed concurrently with hysterectomy.101 Bilateral salpingectomy does not have a negative effect on ovarian function or reserve, although careful surgical technique should focus on minimizing damage to surrounding ovarian tissue.104,107 Patients are at increased risk of repeat surgery for adnexal pathology when the fallopian tubes remain in situ.105
Serum anti-Müllerian hormone concentration before and after salpingectomy for ectopic pregnancy
2018, Reproductive BioMedicine OnlineCitation Excerpt :Although these findings are reassuring, direct extrapolation to surgical treatment for ectopic pregnancy is impossible, as involvement of the adnexa is more extensive in case of a tubal pregnancy. A recent review of 48 studies, investigating the effect of salpingectomy for different indications on a wide variety of outcome measures, found that among all the studies reporting an impairment of ovarian reserve parameters by salpingectomy, the indication had most often been an ectopic pregnancy (Kotlyar et al., 2017). Also, a recent retrospective cohort study investigated whether the response to ovarian stimulation following salpingectomy was affected by the underlying indication for salpingectomy, and found that women salpingectomized for ectopic pregnancy required longer duration of stimulation and higher gonadotrophin dosage compared with women salpingectomized for other indications (Pereira et al., 2017).
The authors declare that they have no conflict of interest.