The Effect of Tubal and Ovarian Surgery on Ovarian Function in Cycles of Controlled Stimulation in Patients Undergoing In Vitro Fertilization

The ability of ovaries to respond to induction with human menopausal gonadotropin (hMG) with regard to prior ovarian and tubal surgery was retrospectively analyzed in patients undergoing in vitro fertilization. Comparing sides within 19 women who had undergone cystectomy on one ovary and no surgery on the other, there were no significant differences (p > 0.05) noted in either the number of small, large, or total follicles on day −1, day 0, or day +1 or in the quantity and maturity of oocytes recovered. Similarly, there was no significant difference noted in response to stimulation comparing the ovary ipsilateral to a previous salpingectomy vs the ovary associated with a contralateral tuboplasty (n = 18). In a third cohort, three groups of patients with different surgical histories were evaluated. Comparing women with bilateral cystectomy (n= 15), unilateral cystectomy (n = 18), and bilateral tuboplasty (n = 44), there was no difference in folliculogenesis, estradiol levels, or quantity and maturity of oocyte recovered. These findings suggest that the prognosis for ovarian response to induction of multiple follicular development is independent of past ovarian and tubal surgery.