Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Laboratory of Translational Fertility Preservation, Karolinska Institute, Stockholm, Sweden; Department of Reproductive Medicine, Division of Gynaecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Fertil Steril. 2022 May;117(5):992-1002. doi: 10.1016/j.fertnstert.2022.01.033. Epub 2022 Mar 8.
To quantify the effect of unilateral oophorectomy (UO) on the rates of live birth and pregnancy in women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
Systematic review and meta-analysis.
Search of databases of published articles.
PATIENT(S): The final analytical cohort encompassed 1,057 IVF/ICSI cycles in women with previous UO and 45,813 IVF/ICSI cycles in control women. Eighteen studies were identified by database searches of MEDLINE, Embase, Web of Science, and cited references. The review encompassed studies published up to June 1, 2021.
INTERVENTION(S): UO prior to IVF/ICSI.
MAIN OUTCOME MEASURE(S): The primary outcomes were the rates of live birth and pregnancy following IVF/ICSI. The secondary outcomes included the amount of gonadotropins administered for ovarian stimulation and the number of retrieved oocytes.
RESULT(S): The studies were rated from medium to high quality (from 5 to 8) according to the Newcastle-Ottawa Quality Assessment Scale. All studies were observational, with inherent bias, and heterogeneity was high. The primary outcome of live birth had a significantly lower odds ratio (OR) in women with previous UO compared with controls (OR = 0.72, 95% confidence interval [CI] 0.57 to 0.91, z = -2.72). The OR for pregnancy rate per initiated treatment cycle was also significantly lower in women with previous UO compared with controls (OR = 0.70, 95% CI 0.57 to 0.86, z = -3.35). Additionally, the dose of administered gonadotropins was significantly higher and the number of retrieved oocytes was significantly lower in women with UO.
CONCLUSION(S): The meta-analysis showed a significant detrimental effect of UO on the rates of live birth and pregnancy. The analysis further supports previous data showing a decreased sensitivity to gonadotropins and a lower number of recovered oocytes in women with previous UO.
PROSPERO 2020, CRD42020160313.
定量分析单侧卵巢切除术（UO）对接受体外受精/胞浆内单精子注射（IVF/ICSI）的女性活产率和妊娠率的影响。
系统评价和荟萃分析。
检索已发表文献的数据库。
最终分析队列包括 1057 例接受过 UO 的 IVF/ICSI 周期和 45813 例对照女性的 IVF/ICSI 周期。通过对 MEDLINE、Embase、Web of Science 和参考文献的数据库搜索，确定了 18 项研究。本综述涵盖了截至 2021 年 6 月 1 日发表的研究。
UO 发生于 IVF/ICSI 之前。
主要结局指标是 IVF/ICSI 后活产率和妊娠率。次要结局指标包括卵巢刺激用促性腺激素用量和获卵数。
根据纽卡斯尔-渥太华质量评估量表，这些研究的质量从中等到高（5 至 8 分）。所有研究均为观察性研究，存在固有偏倚，且异质性较高。与对照组相比，既往有 UO 的女性活产的优势比（OR）显著降低（OR=0.72，95%置信区间[CI]0.57 至 0.91，z=-2.72）。与对照组相比，既往有 UO 的女性的妊娠率 per 起始治疗周期的 OR 也显著降低（OR=0.70，95%CI0.57 至 0.86，z=-3.35）。此外，UO 女性的促性腺激素用量显著增加，获卵数显著减少。
荟萃分析表明 UO 对活产率和妊娠率有显著的不利影响。该分析进一步支持了先前的数据，即既往有 UO 的女性对促性腺激素的敏感性降低，且回收的卵母细胞数量减少。
PROSPERO 2020，CRD42020160313。
