Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis

Abstract Background Survival rates of young women undergoing cancer treatment have substantially improved, with a focus on post-treatment quality of life. Ovarian tissue transplantation (OTT) is a viable option to preserve fertility; however, there is no consensus on the optimal transplantation site...

Full description

Bibliographic Details
Main Authors: Baoli Xie, Jiaxu Li, Yingqin Huang, Fu Hang, Qianwen Hu, Jiaxin Yu, Aiping Qin
Format: Article
Language:English
Published: BMC 2023-12-01
Series:Reproductive Biology and Endocrinology
Subjects:
Online Access:https://doi.org/10.1186/s12958-023-01167-6
_version_ 1797388022919987200
author Baoli Xie
Jiaxu Li
Yingqin Huang
Fu Hang
Qianwen Hu
Jiaxin Yu
Aiping Qin
author_facet Baoli Xie
Jiaxu Li
Yingqin Huang
Fu Hang
Qianwen Hu
Jiaxin Yu
Aiping Qin
author_sort Baoli Xie
collection DOAJ
description Abstract Background Survival rates of young women undergoing cancer treatment have substantially improved, with a focus on post-treatment quality of life. Ovarian tissue transplantation (OTT) is a viable option to preserve fertility; however, there is no consensus on the optimal transplantation site. Most studies on OTT are nonrandomized controlled trials with limited sample sizes and uncontrolled statistical analyses, leaving the question of which transplant site yields the highest chance of achieving a live birth unanswered. Objective This meta-analysis aimed to assess the effect of different ovarian transplant sites on postoperative reproductive outcomes. Methods We adhered to the PRISMA Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Systematic searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Library from inception to September 17, 2023. The inclusion criteria were as follows: (1) women who underwent OTT with a desire for future childbirth, and (2) reports of specific transplant sites and corresponding pregnancy outcomes. The exclusion criteria included the inability to isolate or extract relevant outcome data, case reports, non-original or duplicate data, and articles not written in English. Results Twelve studies (201 women) were included in the meta-analysis of cumulative live birth rates (CLBR) after OTT. The CLBR, which encompasses both spontaneous pregnancies and those achieved through assisted reproductive technology (ART) following OTT to the ovarian site, was 21% (95% CI: 6–40, I2: 52.81%, random effect). For transplantation to the pelvic site, the live birth rate was 30% (95% CI: 20–40, I2: 0.00%, fixed effect). Combining transplantation to both the pelvic and ovarian sites resulted in a live birth rate of 23% (95% CI: 11–36, I2: 0.00%, fixed effect). Notably, heterotopic OTT yielded a live birth rate of 3% (95% CI: 0–17, I2: 0.00%, fixed effect). Conclusion Pregnancy outcomes were not significantly different after orthotopic ovarian transplantation, and pregnancy and live birth rates after orthotopic OTT were significantly higher than those after ectopic transplantation. Registration Number INPLASY202390008.
first_indexed 2024-03-08T22:34:42Z
format Article
id doaj.art-d7d3c7d74ba44b16896abfb72f0c94e9
institution Directory Open Access Journal
issn 1477-7827
language English
last_indexed 2024-03-08T22:34:42Z
publishDate 2023-12-01
publisher BMC
record_format Article
series Reproductive Biology and Endocrinology
spelling doaj.art-d7d3c7d74ba44b16896abfb72f0c94e92023-12-17T12:33:51ZengBMCReproductive Biology and Endocrinology1477-78272023-12-0121111010.1186/s12958-023-01167-6Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysisBaoli Xie0Jiaxu Li1Yingqin Huang2Fu Hang3Qianwen Hu4Jiaxin Yu5Aiping Qin6Center of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityCenter of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityCenter for Reproductive Medicine, Maternal and Child Health Hospital in GuangxiCenter of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityCenter of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityCenter of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityCenter of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical UniversityAbstract Background Survival rates of young women undergoing cancer treatment have substantially improved, with a focus on post-treatment quality of life. Ovarian tissue transplantation (OTT) is a viable option to preserve fertility; however, there is no consensus on the optimal transplantation site. Most studies on OTT are nonrandomized controlled trials with limited sample sizes and uncontrolled statistical analyses, leaving the question of which transplant site yields the highest chance of achieving a live birth unanswered. Objective This meta-analysis aimed to assess the effect of different ovarian transplant sites on postoperative reproductive outcomes. Methods We adhered to the PRISMA Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Systematic searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Library from inception to September 17, 2023. The inclusion criteria were as follows: (1) women who underwent OTT with a desire for future childbirth, and (2) reports of specific transplant sites and corresponding pregnancy outcomes. The exclusion criteria included the inability to isolate or extract relevant outcome data, case reports, non-original or duplicate data, and articles not written in English. Results Twelve studies (201 women) were included in the meta-analysis of cumulative live birth rates (CLBR) after OTT. The CLBR, which encompasses both spontaneous pregnancies and those achieved through assisted reproductive technology (ART) following OTT to the ovarian site, was 21% (95% CI: 6–40, I2: 52.81%, random effect). For transplantation to the pelvic site, the live birth rate was 30% (95% CI: 20–40, I2: 0.00%, fixed effect). Combining transplantation to both the pelvic and ovarian sites resulted in a live birth rate of 23% (95% CI: 11–36, I2: 0.00%, fixed effect). Notably, heterotopic OTT yielded a live birth rate of 3% (95% CI: 0–17, I2: 0.00%, fixed effect). Conclusion Pregnancy outcomes were not significantly different after orthotopic ovarian transplantation, and pregnancy and live birth rates after orthotopic OTT were significantly higher than those after ectopic transplantation. Registration Number INPLASY202390008.https://doi.org/10.1186/s12958-023-01167-6Ovarian tissue cryopreservation (OTC)Ovarian tissue transplantation (OTT)Transplant sitesReproductive outcomesSingle-arm meta-analysis
spellingShingle Baoli Xie
Jiaxu Li
Yingqin Huang
Fu Hang
Qianwen Hu
Jiaxin Yu
Aiping Qin
Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
Reproductive Biology and Endocrinology
Ovarian tissue cryopreservation (OTC)
Ovarian tissue transplantation (OTT)
Transplant sites
Reproductive outcomes
Single-arm meta-analysis
title Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
title_full Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
title_fullStr Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
title_full_unstemmed Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
title_short Assessing the impact of transplant site on ovarian tissue transplantation: a single-arm meta-analysis
title_sort assessing the impact of transplant site on ovarian tissue transplantation a single arm meta analysis
topic Ovarian tissue cryopreservation (OTC)
Ovarian tissue transplantation (OTT)
Transplant sites
Reproductive outcomes
Single-arm meta-analysis
url https://doi.org/10.1186/s12958-023-01167-6
work_keys_str_mv AT baolixie assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT jiaxuli assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT yingqinhuang assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT fuhang assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT qianwenhu assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT jiaxinyu assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis
AT aipingqin assessingtheimpactoftransplantsiteonovariantissuetransplantationasinglearmmetaanalysis