Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review
Background: In vitro fertilization (IVF) with egg donation often stands as the sole treatment option for women with premature ovarian insufficiency (POI) or poor ovarian response (POR); for this reason, alternative techniques are being developed, among which stand surgical techniques for ovarian act...
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| Format: | Article |
| Language: | English |
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Royan Institute (ACECR), Tehran
2025-04-01
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| Series: | International Journal of Fertility and Sterility |
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| Online Access: | https://www.ijfs.ir/article_718872_efabe9ed4fee3cf10a593a56a16efb79.pdf |
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| author | Antonio D'Amato Antonio Simone Laganà Amerigo Vitagliano Antonio Stanziano Anna Maria Caringella Clementina Cantatore Giuseppe D’Amato Giovanni Buzzaccarini Andrea Etrusco |
| author_facet | Antonio D'Amato Antonio Simone Laganà Amerigo Vitagliano Antonio Stanziano Anna Maria Caringella Clementina Cantatore Giuseppe D’Amato Giovanni Buzzaccarini Andrea Etrusco |
| author_sort | Antonio D'Amato |
| collection | DOAJ |
| description | Background: In vitro fertilization (IVF) with egg donation often stands as the sole treatment option for women with premature ovarian insufficiency (POI) or poor ovarian response (POR); for this reason, alternative techniques are being developed, among which stand surgical techniques for ovarian activation. The aim of the present study was to evaluate the effectiveness of surgical techniques for ovarian activation in patients affected by POI or POR.Materials and Methods: In this systematic review study, a comprehensive search of the literature was carried out on the principal databases. Only original studies reporting the treatment of POI or POR using surgical techniques for ovarian activation in human subjects were deemed eligible for inclusion in this qualitative analysis.Results: Overall, 187 patients with POI and 65 patients with POR were treated with experimental surgical techniques. Among the POI patients, 10 pregnancies and 8 live births were achieved. In the POR group, 18 pregnancies were reported with 14 live births.Conclusion: Ovarian fragmentation (OF) appears to be a promising method for treating POI, although large sample randomized controlled trials (RCTs) are necessary to confirm this hypothesis. Regarding POR, surgical techniques do not improve IVF outcomes, and thus should not be proposed, although they may lead to a slight increase in ovarian reserve markers as compared with before treatment. Both clinical and basic science studies are highly demanded to better understand the molecular mechanisms underlying some partially promising results, with the aim of improving currently available techniques. |
| format | Article |
| id | doaj-art-8adeac75ede04b97bf1cb00f235a6e3b |
| institution | DOAJ |
| issn | 2008-076X 2008-0778 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Royan Institute (ACECR), Tehran |
| record_format | Article |
| series | International Journal of Fertility and Sterility |
| spelling | doaj-art-8adeac75ede04b97bf1cb00f235a6e3b2025-08-20T03:06:10ZengRoyan Institute (ACECR), TehranInternational Journal of Fertility and Sterility2008-076X2008-07782025-04-0119213314310.22074/ijfs.2024.2021822.1622718872Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic ReviewAntonio D'Amato0Antonio Simone Laganà1Amerigo Vitagliano2Antonio Stanziano3Anna Maria Caringella4Clementina Cantatore5Giuseppe D’Amato6Giovanni Buzzaccarini7Andrea Etrusco8Department of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology, University of Bari, Bari, ItalyUnit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, ItalyDepartment of Interdisciplinary Medicine (DIM), Unit of Obstetrics and Gynecology, University of Bari, Bari, ItalyDepartment of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, ItalyDepartment of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, ItalyDepartment of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, ItalyDepartment of Advanced Reproductive Risk Management and High-Risk Pregnancies, ASL Bari, Reproductive and IVF Unit, PTA Conversano, Conversano, ItalyObstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, ItalyUnit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, ItalyBackground: In vitro fertilization (IVF) with egg donation often stands as the sole treatment option for women with premature ovarian insufficiency (POI) or poor ovarian response (POR); for this reason, alternative techniques are being developed, among which stand surgical techniques for ovarian activation. The aim of the present study was to evaluate the effectiveness of surgical techniques for ovarian activation in patients affected by POI or POR.Materials and Methods: In this systematic review study, a comprehensive search of the literature was carried out on the principal databases. Only original studies reporting the treatment of POI or POR using surgical techniques for ovarian activation in human subjects were deemed eligible for inclusion in this qualitative analysis.Results: Overall, 187 patients with POI and 65 patients with POR were treated with experimental surgical techniques. Among the POI patients, 10 pregnancies and 8 live births were achieved. In the POR group, 18 pregnancies were reported with 14 live births.Conclusion: Ovarian fragmentation (OF) appears to be a promising method for treating POI, although large sample randomized controlled trials (RCTs) are necessary to confirm this hypothesis. Regarding POR, surgical techniques do not improve IVF outcomes, and thus should not be proposed, although they may lead to a slight increase in ovarian reserve markers as compared with before treatment. Both clinical and basic science studies are highly demanded to better understand the molecular mechanisms underlying some partially promising results, with the aim of improving currently available techniques.https://www.ijfs.ir/article_718872_efabe9ed4fee3cf10a593a56a16efb79.pdfinfertilitypremature ovarian insufficiencyovarian reserve |
| spellingShingle | Antonio D'Amato Antonio Simone Laganà Amerigo Vitagliano Antonio Stanziano Anna Maria Caringella Clementina Cantatore Giuseppe D’Amato Giovanni Buzzaccarini Andrea Etrusco Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review International Journal of Fertility and Sterility infertility premature ovarian insufficiency ovarian reserve |
| title | Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review |
| title_full | Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review |
| title_fullStr | Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review |
| title_full_unstemmed | Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review |
| title_short | Ovarian Activation Surgical Techniques for Women with Premature Ovarian Insufficiency or Poor Ovarian Response: A Systematic Review |
| title_sort | ovarian activation surgical techniques for women with premature ovarian insufficiency or poor ovarian response a systematic review |
| topic | infertility premature ovarian insufficiency ovarian reserve |
| url | https://www.ijfs.ir/article_718872_efabe9ed4fee3cf10a593a56a16efb79.pdf |
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