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Cochrane Database of Systematic Reviews

Surgery for tubal infertility

Overview of attention for article published in Cochrane database of systematic reviews, January 2017
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Surgery for tubal infertility
Published in
Cochrane database of systematic reviews, January 2017
DOI 10.1002/14651858.cd006415.pub3
Pubmed ID

Su Jen Chua, Valentine A Akande, Ben Willem J Mol


Surgery remains an acceptable treatment modality for tubal infertility despite the rise in usage of in vitro fertilisation (IVF). Estimated livebirth rates after surgery range from 9% for women with severe tubal disease to 69% for those with mild disease; however, the effectiveness of surgery has not been rigorously evaluated in comparison with other treatments such as IVF and expectant management (no treatment). Livebirth rates have not been adequately assessed in relation to the severity of tubal damage. It is important to determine the effectiveness of surgery against other treatment options in women with tubal infertility because of concerns about adverse outcomes, intraoperative complications and costs associated with tubal surgery, as well as alternative treatments, mainly IVF. The aim of this review was to determine the effectiveness and safety of surgery compared with expectant management or IVF in improving the probability of livebirth in the context of tubal infertility (regardless of grade of severity). We searched the following databases in October 2016: the Cochrane Gynaecology and Fertility (CGF) Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO; as well as clinical trials registries, sources of unpublished literature and reference lists of included trials and related systematic reviews. We considered only randomised controlled trials to be eligible for inclusion, with livebirth rate per participant as the primary outcome of interest. We planned that two review authors would independently assess trial eligibility and risk of bias and would extract study data. The primary review outcome was cumulative livebirth rate. Pregnancy rate and adverse outcomes, including miscarriage rate, rate of ectopic pregnancy and rate of procedure-related complications, were secondary outcomes. We planned to combine data to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We planned to assess statistical heterogeneity using the I(2) statistic and to assess the overall quality of evidence for the main comparisons using GRADE methods. We identified no suitable randomised controlled trials. The effectiveness of tubal surgery relative to expectant management and IVF in terms of livebirth rates for women with tubal infertility remains unknown. Large trials with adequate power are warranted to establish the effectiveness of surgery in these women. Future trials should not only report livebirth rates per patient but should compare adverse effects and costs of treatment over a longer time. Factors that have a major effect on these outcomes, such as fertility treatment, female partner's age, duration of infertility and previous pregnancy history, should be considered. Researchers should report livebirth rates in relation to severity of tubal damage and different techniques used for tubal repair, including microsurgery and laparoscopic methods.

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X Demographics

The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 206 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 206 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 31 15%
Student > Bachelor 22 11%
Other 16 8%
Researcher 14 7%
Student > Postgraduate 12 6%
Other 39 19%
Unknown 72 35%
Readers by discipline Count As %
Medicine and Dentistry 65 32%
Nursing and Health Professions 22 11%
Psychology 7 3%
Pharmacology, Toxicology and Pharmaceutical Science 6 3%
Computer Science 5 2%
Other 26 13%
Unknown 75 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2018.
All research outputs
of 25,390,970 outputs
Outputs from Cochrane database of systematic reviews
of 12,525 outputs
Outputs of similar age
of 416,166 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 251 outputs
Altmetric has tracked 25,390,970 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 12,525 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 37.2. This one is in the 10th percentile – i.e., 10% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 416,166 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 37th percentile – i.e., 37% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 251 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.