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 pelvic fractures (PFs) upon female fertility and live birth rate, as data including treatment regimens in large, unselected 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; I  = 18%) and dyspareunia HR 0.60 (95% CI 0.34-1.08, P = 0.09; I  = 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.