Unilateral oophorectomy results in compensatory follicular recruitment in the remaining ovary at time of ovarian stimulation for in vitro fertilization

Capsule:
Women with a prior unilateral oophorectomy have compensatory follicular recruitment in the remaining ovary, and right ovaries respond better than left ovaries after stimulation for IVF.

Authors:
Zaraq Khan, M.B.B.S., Ravi P. Gada, M.D., Zaid M. Tabba, M.D., Shannon K. Laughlin-Tommaso, M.D., Jani R. Jensen, M.D., Charles C. Coddington, M.D., Elizabeth A. Stewart, M.D.

Volume 101, Issue 3, Pages 722-727, March 2014

Abstract:

Objective:
To assess the effect of unilateral oophorectomy (UO) by assessing ovarian reserve (OVR) and the response to gonadotropin stimulation in women with UO undergoing in vitro fertilization (IVF) compared with the response of the ipsilateral ovary of women without UO.

Design:
Historical cohort study.

Setting:
Academic fertility clinic.

Patient(s):
Fifty-one women with single ovary compared with a referent group with both ovaries in a 1:2 fashion.

Intervention(s):
None.

Main Outcome Measure(s):
Day-3 follicle-stimulating hormone (FSH), estradiol, and antral follicle counts as measures of OVR, and IVF outcomes including number of follicles aspirated and oocytes retrieved.

Result(s):
The baseline demographics and serum markers of OVR were not different. Referent women had greater follicular yield and oocyte numbers when compared with women with UO; however, when compared with the ipsilateral ovary of the referents, women with UO had a higher antral follicle count and greater follicle and oocyte numbers. In multivariate analyses, the ovary from women with UO was more likely to yield more than the median number of follicles and oocytes than the ipsilateral ovary in referent women. Live-birth rates in both groups were similar.

Conclusion(s):
Our results suggest that the remaining ovary appears to compensate in follicular yield after UO in women, confirming the animal data. Women with UO can be reassured and appropriately counseled regarding IVF.

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