The impact of unilateral oophorectomy on ovarian reserve in assisted reproduction: a systematic review and meta‐analysis

BACKGROUND: Women following unilateral oophorectomy (UO) are occasionally encountered during assisted reproduction treatment. OBJECTIVE: To explore the impact of UO on ovarian reserve in assisted reproduction. SEARCH STRATEGY: An electronic database search was performed using PubMed, EBSCO, ISI, Trip, ClinicalTrial.gov and the Cochrane library followed by a manual search to identify published research between January 1978 and December 2015. SELECTION CRITERIA: Controlled studies that compared infertile women following UO undergoing IVF-ET treatment with women with two intact ovaries. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted the data concerning the impact of UO on ovarian reserve tests, ovarian response to controlled ovarian hyperstimulation and clinical pregnancy rate. Meta-analysis was performed using these measures. MAIN RESULTS: level on the day of hCG administration was significant (WMD: -431 pg/ml; 95% CI: -616 to -246, P < 0.001). However, the weighted overall odds ratio (OR) of clinical pregnancy between women with a single ovary and women with two ovaries was comparable (overall OR: 0.76; 95% CI: 0.57-1.00, P = 0.054). All eligible studies were retrospectively conducted and the heterogeneity among ovarian response measures was high. CONCLUSIONS: Available pooled data supports an adverse effect of UO on ovarian reserve involving the quantity but not the quality of the ovarian pool. TWEETABLE ABSTRACT: Review finds women with one ovary removed have less IVF capacity but the same pregnancy rate as women with two ovaries.