Fertility and reproductive outcomes following high-energy pelvic fractures: A systematic review and meta-analysis

Background: There  is  a  need  to  decipher  the  effect  of high-energy pelvic  fractures  (PFs)  upon  female fertility and live birth rate, as data including treatment regimens in large populations remain scarce.

Objectives: To assess the effect of high energy PFs upon female fertility and live birth rate. Search strategy: Literature  search  for  relevant  studies  was  performed  up  to  March  2022  in  five  databases:  Embase,  MEDLINE,  CAB  Abstracts,  ClinicalTrials.gov,  and Google Scholar. Selection criteria: Retrospective studies assessing live birth, infertility, and dyspareunia rates following PFs. Data collection and analysis: Data  were  extracted  from  studies  independently  by two authors. The quality of the included studies was assessed using the Newcastle- Ottawa Scale (NOS) for observational studies.

Main results: A total of 763 female patients of median age 27.8 years (95% CI 22– 38 years) were included with median follow up of 5 years. Among PF patients, infertility hazard ratio (HR) 1.18 (95% CI 0.76–1.84, P= 0.47; I2= 18%) and dyspareunia HR 0.60 (95% CI 0.34–1.08, P= 0.09; I2= 66%), did not significantly differ from the age- matched literature- reported rates among non-PF patients.

Conclusions: No significant differences of live birth, infertility, and dyspareunia rates across patients with PFs were found compared with non-PF counterparts.