“The effect of salpingectomy on the ovarian reserve and ovarian response in ectopic pregnancy”

Journal- Medicine (Baltimore)

For ectopic pregnancy, salpingectomy is indicated rather than methotrexate in certain cases, such as a high beta-hCG, a mass over 3 cm, or hemodynamic instability. While salpingectomy is very effective in reducing recurrence of ectopic pregnancy, concerns have been raised as to how it affects the ovarian reserve, considering the resulting decrease in blood flow to the ipsilateral ovary. The ovaries are typically supplied mainly by the ovarian arteries with some supply from the uterine artery via the mesosalpinx. This meta-analysis included seven articles: two prospective studies and five retrospective studies. This meta-analysis concluded that there was no significant impact to ovarian function in patients receiving a salpingectomy for ectopic pregnancy, as evaluated by levels of Anti-Müllerian hormone (AMH), basal FSH, and antral follicle count (AFC), among other parameters. In some studies, the patients’ levels were evaluated before and after the salpingectomy, with no significant change. One study found that while the ovary ipsilateral to the salpingectomy had fewer oocytes compared to the opposite side, these women still had similar oocyte retrieval rates as women who had never undergone a salpingectomy. Furthermore, it was found that women in the salpingectomy group, did indeed use higher levels of gonadotropin for IVF. Overall the study advises clinicians to perform salpingectomies when indicated, without concern for effects on future fertility.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882622/