Zhongguo quanke yixue (Mar 2024)

Short-term Effects of Opportunistic Salpingectomy on Ovarian Reserve: a Meta-analysis of Randomized Controlled Trials Based on GRADE Evidence Grading System

  • ZHAO Li, YANG Chunyan, ZUO Manyun, YANG Hongmei

DOI
https://doi.org/10.12114/j.issn.1007-9572.2023.0165
Journal volume & issue
Vol. 27, no. 09
pp. 1142 – 1148

Abstract

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Background Opportunistic salpingectomy (OS) can be used as a primary prevention of ovarian cancer (OC) , but OS may cause impairment of ovarian function due to the homologous blood supply system shared by ovaries and fallopian tubes, thereby increasing the risk of ovarian aging and early menopause. Objective To evaluate the short-term effects of OS on ovarian reserve based on GRADE evidence grading system. Methods In September 2022, CNKI, Wanfang, VIP, PubMed, Web of Science, and Scopus were searched for literature assessing the short-term effects of OS on ovarian reserve from inception to 10 September 2022. Two investigators independently screened the literature and extracted the data. The Jadad scale was used to evaluate the quality of literature, Stata 17.0 software was used for data processing and meta-analysis, and GRADEpro 3.2 software was used to assess the evidence quality for the results of meta-analysis. Results A total of 9 randomized controlled trials (RCT) were included, involving 482 patients, including 238 cases in the OS group and 244 in the non-OS group. The results of the Jadad risk assessment scale showed that the included RCTs were all of high quality literature. The results of meta-analysis showed that the differences in changes of anti-mullerian hormone (AMH) (WMD=-0.07, 95%CI=-0.28-0.13, P=0.13) , follicle-stimulating hormone (FSH) (WMD=-0.03, 95%CI=-1.65-1.59, P=0.24) , luteinizing hormone (LH) (WMD=-0.39, 95%CI=-1.62-0.83, P=0.08) and estradiol (E2) (WMD=3.08, 95%CI=-4.26-10.43, P=0.35) before and after surgery between the OS and non-OS groups were not significant (P>0.05) . The results of the meta-analysis by GRADEpro software showed high quality evidence for AMH, moderate quality evidence for FSH, and low quality evidence for E2 and LH. Conclusion There is no significant difference in ovarian reserve indicators between the non-menopausal women who receive OS for benign disease in the short term and those who did not receive OS. It is reasonable for premenopausal women who have completed childbearing to prevent OC by OS, but this conclusion remains to be validated by a longer follow-up and more rigorous RCTs with a larger sample size.

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