Is Pregnancy Possible After In Vitro Fertilization (IVF) With Just One Ovary?

Highlights:

• Ovary removal surgery is necessary in many cases but its effect on fertility is not known
• Previous studies that believed fertility was unaffected were too small to follow
• In such a case, women should be informed about its impact on pregnancy and childbirth

Women who have a single ovary due to surgery have a low chance of becoming pregnant after in vitro fertilization (IVF) and give birth to fewer babies than women with both ovaries, according to an extensive meta-analysis published in the journal Fertility and Sterility.

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Ovary Removal Surgery

An oophorectomy is a surgical procedure for one or both ovaries. When one ovary is removed, it is called unilateral oophorectomy. This method is used in the treatment of large ovarian cysts, pelvic inflammatory disease, ectopic pregnancy and to lower the risk of ovarian cancer in vulnerable women carrying mutations of the BRCA1 or BRCA2 genes. This is seen as an elective or preventive oophorectomy.

Data regarding the impact of fertility by removing one ovary has been inconclusive to date, but it was believed that the remaining ovary could compensate for the loss in women undergoing treatment with IVF.

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Is IVF Successful?

To know whether IVF is successful for women with a single ovary, researchers at Karolinska Institute conducted a meta-analysis study.

“Our meta-study shows that a successful IVF outcome was less likely in women that have only one ovary, compared with women with both intact ovaries,” says Kenny Rodriguez-Wallberg, adjunct professor at the department of oncology-pathology, Karolinska Institute, and consultant at Karolinska University Hospital.

Researchers review published studies to compare their results against their point of inquiry in this meta-analysis. They identified more than 3,000 papers on the subject, of which 18, published between 1984 and 2018, met their criteria and were selected for the final analysis.

Taken together, studies included 1,057 IVF attempts for women with one ovary and 45,813 for women with two. Five of the studies were included in the analyses of live births, 15 in the analysis of pregnancy rate.

It also shows that the chance of becoming pregnant and giving birth was low compared to that of women with both ovaries. Though the surgery is necessary for a malignant tumor, it is important to improve the information given to women about what it can mean for their chances of having future children.

The main reason for the previous belief that fertility was unaffected is that most of the studies carried out were too small to provide an impactful result to follow.

Researchers now want to examine if the surgical removal of the ovary has any other health effects, such as reduced hormone production and the development of other diseases.

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Solution to Infertility

The physician will discuss the risks of the surgery as a pre-surgery protocol. If they advise you to have this surgery, it means the benefits outweigh the risks.

Low-dose hormone therapy, or other medications, and lifestyle changes will be recommended to help with the risks. If the doctor removes only one ovary, the remaining ovary will probably produce estrogen and you will be able to get pregnant. If they remove both ovaries, in vitro fertilization treatment is needed.

Considering the limited biological reserve of eggs, they can be removed from the ovaries before surgery and they should keep frozen for future use. Talk to your doctor about the options.

References:

1. Oophorectomy - (https://my.clevelandclinic.org/health/treatments/17800-oophorectomy)
2. Surgery for Ovarian Cysts - (https://www.uofmhealth.org/health-library/hw178611)

Source-Medindia