Hide
Show all
Email this article Fertility After Unilateral Oophorectomy: A Review of Assisted Reproductive Technology Outcomes
Abstract
Background: Unilateral oophorectomy (UO), the surgical removal of one ovary, remains a necessary intervention for various gynecologic conditions despite a general trend toward more conservative treatments. As increasing numbers of women with a single ovary participate in assisted reproductive technology (ART) programs, understanding the impact of UO on fertility outcomes is essential. Though ovarian reserve may be diminished, compensatory mechanisms may preserve reproductive potential. Clarifying this relationship can inform patient counseling and treatment planning.
Aim: To evaluate whether unilateral oophorectomy significantly affects outcomes in assisted reproductive technologies (ART), particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), through a systematic review of the literature.
Methods: A literature review was conducted using PubMed and Google Scholar databases. The search included articles published in English from January 1987 to December 2024 using the keywords “unilateral oophorectomy” AND “assisted reproduction.” After removing duplicates and studies that did not meet inclusion criteria, 9 articles were included in the final analysis. These studies varied in design (prospective, retrospective, cohort studies, and systematic reviews) and sample size, but all focused on ART outcomes in women with one ovary compared to those with two.
Results: The selected studies demonstrated that women with a single ovary generally have a reduced ovarian response, including fewer follicles, lower peak estradiol levels, and fewer retrieved oocytes. However, in most studies, clinical pregnancy and live birth rates remained comparable to those of women with two ovaries. Some studies even reported higher pregnancy rates in the UO group. Evidence of compensatory ovarian function in the remaining ovary was observed, including increased antral follicle count and follicular yield. Differences in ovarian stimulation protocols and patient characteristics influenced the magnitude of response, but ART success rates were not significantly compromised overall.
Conclusions: Despite reduced ovarian reserve and response in women with unilateral oophorectomy, ART outcomes—including pregnancy and live birth rates—are largely comparable to those in women with two ovaries. This suggests that the remaining ovary may compensate functionally, supporting satisfactory reproductive outcomes. Women who have undergone UO can be counseled with confidence regarding their fertility potential with ART. Further research is warranted to explore mechanisms of ovarian compensation and optimize treatment protocols for this population
Keywords
Full Text:
PDFReferences
Laughlin-Tommaso SK, Stewart EA, Grossardt BR, Rocca LG, Rocca WA. Incidence, time trends, laterality, indications, and pathological findings of unilateral oophorectomy before menopause. Menopause. 2014;21(5):442-449. doi:10.1097/GME.0b013e3182a3ff45
Gasparri ML, Ruscito I, Braicu EI, et al. Biological Impact of Unilateral Oophorectomy: Does the Number of Ovaries Really Matter?. Geburtshilfe Frauenheilkd. 2021;81(3):331-338. doi:10.1055/a-1239-3958
Page M J, McKenzie J E, Bossuyt P M, Boutron I, Hoffmann T C, Mulrow C D et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews BMJ 2021; 372 :n71 doi:10.1136/bmj.n71
Boutteville C, Muasher SJ, Acosta AA, Jones HW Jr, Rosenwaks Z. Results of in vitro fertilization attempts in patients with one or two ovaries. Fertil Steril. 1987;47(5):821-827. doi:10.1016/s0015-0282(16)59172-9
Levitas E, Furman B, Shoham-Vardi I, Lunenfeld E, Potashnik G. Treatment outcome in women with a single ovary versus patients with two ovaries undergoing in vitro fertilization and embryo transfer (IVF/ET). Eur J Obstet Gynecol Reprod Biol. 2000;88(2):197-200. doi:10.1016/s0301-2115(99)00155-4
Levi R, Özçakir HT, Alatas E, Göker EN, Tavmergen E. The outcomes of assisted reproductive technology cycles in patients with one or two ovaries. Journal of obstetrics and gynaecology research. 2003 Oct;29(5):321-5.
Al-Hasani S, Asimakopoulos B, Nikolettos N, Diedrich K. Comparison of the response to ovarian stimulation between women with one ovary and those with two ovaries, in a program of ICSI/ET. Acta Obstet Gynecol Scand. 2003;82(9):845-849. doi:10.1034/j.1600-0412.2003.00201.x
Hendricks MS, Chin H, Loh SF. Treatment outcome of women with a single ovary undergoing in vitro fertilisation cycles. Singapore Med J. 2010;51(9):698-701.
Khan Z, Gada RP, Tabbaa ZM, et al. Unilateral oophorectomy results in compensatory follicular recruitment in the remaining ovary at time of ovarian stimulation for in vitro fertilization. Fertil Steril. 2014;101(3):722-727. doi:10.1016/j.fertnstert.2013.11.019
Younis JS, Naoum I, Salem N, Perlitz Y, Izhaki I. The impact of unilateral oophorectomy on ovarian reserve in assisted reproduction: a systematic review and meta-analysis. BJOG. 2018;125(1):26-35. doi:10.1111/1471-0528.14913
Lind T, Holte J, Olofsson JI, et al. Reduced live-birth rates after IVF/ICSI in women with previous unilateral oophorectomy: results of a multicentre cohort study. Hum Reprod. 2018;33(2):238-247. doi:10.1093/humrep/dex358
Auran E, Cascante S, Blakemore J. Two is not always greater than one: patients with one ovary have similar assisted reproductive technology (ART) outcomes compared to patients with two ovaries. J Assist Reprod Genet. 2022;39(8):1789-1796. doi:10.1007/s10815-022-02534-9
Refbacks
- There are currently no refbacks.
ISSN: 2346-8491 (online)