Birth, pregnancy rates after IVF lower in women with unilateral oophorectomy

Unilateral oophorectomy appears to have a detrimental effect on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes, being associated with lower rates of live birth and pregnancy, according to a meta-analysis.

Researchers performed a systematic review and searched multiple online databases for studies that quantified the effects of unilateral oophorectomy on IVF/ICSI outcomes in women. A total of 18 peer-reviewed articles were included in the meta-analyses.

All included studies were observational, and the final analytical cohort comprised 1,057 IVF/ICSI cycles in women with previous unilateral oophorectomy and 45,813 IVF/ICSI control cycles in women with two ovaries. All analyses were based on fresh embryo transfers.

Five studies were combined for analysis of the primary outcome of live birth rate, while 15 studies were combined for analysis of the co-primary outcome of pregnancy rate. Pooled data showed that compared with women who had two ovaries, those who had undergone unilateral oophorectomy had a significantly lower likelihood of live birth (odds ratio [OR], 0.72, 95 percent confidence interval [CI], 0.57–0.91) and pregnancy rate per initiated treatment cycle (OR, 0.70, 95 percent CI, 0.57–0.86).

Additionally, women with unilateral oophorectomy were administered a significantly higher dose of administered gonadotropins for ovarian stimulation and had a much lower number of retrieved oocytes.

The findings support previous reports of a decreased sensitivity to gonadotropins and a lower number of recovered oocytes among women with prior unilateral oophorectomy.