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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 84-88    DOI: 10.31083/j.ceog.2020.01.5151
Original Research Previous articles | Next articles
Previous ovarian surgery increases the risk of tubal factor infertility
Hue HJ1, †, Kim SK1, 2, Choi JY3, Suh DH1, 2, Kim KD1, 2, No JH1, 2, Lee JR1, 2, Jee BC1, 2, Kim YB1, 2, Jeon HW4, *()
1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam
2Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul
3Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju
4Department of Obstetrics and Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
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Abstract  

Aim: Previous ovarian surgery for endometriosis results in decreased ovarian reserve and poor response to treatment in women with infertility. However, the impact of previous overall ovarian surgery on the incidence of infertility is unclear. Therefore the authors investigated impact of previous ovarian surgery on infertility incidence. Materials and Methods: This is a case-control study using retrospectively collected data in women who received infertility treatment (cases) or delivered babies (controls) at a tertiary center between 2003 and 2012. Results: The frequency of previous ovarian surgery was similar in both groups (p > 0.05) but it was higher in women with tubal infertility than their matched controls (p < 0.05). Also, the frequency of previous reproductive organ surgery was higher in the case group and in women with tubal or unexplained infertility (p < 0.05). Conclusion: Previous ovarian surgery is not associated with entire infertility, but may increase tubal factor infertility through adhesion formation and damage to adjacent tubes.

Key words:  Ovary      Surgery      Infertility      Ovarian reserve      Endometriosis     
Published:  15 February 2020     
*Corresponding Author(s):  Jeon HW     E-mail:  jhwbrmh@gmail.com

Cite this article: 

Hue HJ, Kim SK, Choi JY, Suh DH, Kim KD, No JH, Lee JR, Jee BC, Kim YB, Jeon HW. Previous ovarian surgery increases the risk of tubal factor infertility. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 84-88.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.01.5151     OR     https://ceog.imrpress.com/EN/Y2020/V47/I1/84

Figure 1.  — Flow diagram of patients included in the study of the 664 women who underwent infertility treatment; 210 with unknown height or weight were excluded. Of the 8, 130 women who delivered babies, 3, 661 with a history of infertility or unknown height or weight before pregnancy were excluded. Through propensity score matching, 454 and 908 women were selected as the case and control groups, respectively.

Table 1  — Characteristics of patients.
Case (n=452) Control (n=904)
Year, n (%)
2003 5 (1.1) 24 (2.7)
2004 22 (4.9) 47 (5.2)
2005 27 (6.0) 67 (7.4)
2006 40 (8.8) 74 (8.2)
2007 84 (18.6) 143 (15.8)
2008 50 (11.1) 116 (12.8)
2009 62 (13.7) 79 (8.7)
2010 74 (16.4) 128 (14.2)
2011 67 (14.8) 154 (17.0)
2012 21 (4.6) 72 (8.0)
Age, mean±SD, yr 34±4 34±4
Height, mean±SD, cm 160±5 160±5
Weight, mean±SD, kg 57±8 56±11
Endometriosis, n (%) 41 (9.1) 76 (8.4)
Ectopic pregnancy, n (%) 4 (0.9) 7 (0.8)
Table 2  — Frequency of previous ovarian surgery.

Type of infertility

n
Case Surgery
%

n
Control Surgery
%
All 452 54 11.9 904 90 10.0
Male 55 3 5.5 110 5 4.5
Decreased ovarian reserve 25 2 8.0 50 11 22.0
Ovulatory 22 1 4.5 44 1 2.3
Pelvic 41 20 48.8 82 39 47.6
*Tubal 107 18 16.8 214 13 6.1
Uterine 23 0 0 46 6 13.0
Unexplained 179 10 5.6 358 15 4.2
Table 3  — Frequency of previous surgery to reproductive organs.

Type of infertility

n
Case
surgery

%

n
Control
surgery

%
*All 452 99 21.9 904 120 13.3
Male 55 4 7.3 110 6 5.5
Decreased ovarian reserve 25 5 20.0 50 11 22.0
Ovulatory 22 1 4.5 44 2 4.5
Pelvic 41 22 53.7 82 42 51.2
*Tubal 107 37 34.6 214 28 13.1
Uterine 23 4 17.4 46 6 13.0
*Unexplained 179 26 14.5 358 25 7.0
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