Marco Milone1, Loredana M Sosa Fernandez2, Laura V Sosa Fernandez2, Michele Manigrasso3, Ugo Elmore4, Giovanni D De Palma5, Mario Musella3, Francesco Milone3. 1. Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy. milone.marco.md@gmail.com. 2. Embryos Fertility Center, Battipaglia, Salerno, Italy. 3. Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy. 4. Department of Gastrointestinal Surgery, San Raffaele Hospital, Milan, Italy. 5. Department of Surgery and Advanced Technologies, University of Naples "Federico II", Naples, Italy.
Abstract
BACKGROUND: Little is known about the impact of bariatric surgery on obese infertile women seeking an assisted reproductive technology. METHODS: All obese women with a history of assisted reproductive technology (ART) failure that underwent ART treatment cycles both prior to and following bariatric surgery were included. ART outcomes were compared evaluating the duration and dose of gonadotrophins used; the measurement of day 3 FSH; the anti-mullerian hormone dosage; the number of follicles >15 mm; the number of retrieved and fertilized oocytes; the number of metaphase II, metaphase I and germinal vesicle oocytes; the number of embryos obtained; the number of top-quality oocytes and embryos; the number of transferred embryo; the pregnancy rate and the live birth rate. RESULTS: Forty women were included. The total number of gonadotropin units required and in the length of stimulation following bariatric surgery decreased (p = .001), with an increase of the number of follicles ≥15 mm (p = .005), of retrieved oocytes (p = .004), of top-quality oocytes (p = .001) and metaphase II oocytes (p = .008). More oocytes were fertilized (4.2 ± 1.7 vs 5.3 ± 2.4; p = .02). After surgery, we have registered also a better number of top-quality embryos (0.5 ± 0.6 vs 1.1 ± 0.9; p = .003). Pregnancy rate following the bariatric surgery increased to 15/40 (37.5%) (p < .001), and live birth rate (LBR) increased to 14/40 (35%) in the post-surgery group (p<. 001). CONCLUSIONS: Although additional research would be useful to draw definitive conclusion, our results appear to be encouraging enough to suggest the use of bariatric surgery in obese infertile women seeking an ART treatment.
BACKGROUND: Little is known about the impact of bariatric surgery on obese infertilewomen seeking an assisted reproductive technology. METHODS: All obesewomen with a history of assisted reproductive technology (ART) failure that underwent ART treatment cycles both prior to and following bariatric surgery were included. ART outcomes were compared evaluating the duration and dose of gonadotrophins used; the measurement of day 3 FSH; the anti-mullerian hormone dosage; the number of follicles >15 mm; the number of retrieved and fertilized oocytes; the number of metaphase II, metaphase I and germinal vesicle oocytes; the number of embryos obtained; the number of top-quality oocytes and embryos; the number of transferred embryo; the pregnancy rate and the live birth rate. RESULTS: Forty women were included. The total number of gonadotropin units required and in the length of stimulation following bariatric surgery decreased (p = .001), with an increase of the number of follicles ≥15 mm (p = .005), of retrieved oocytes (p = .004), of top-quality oocytes (p = .001) and metaphase II oocytes (p = .008). More oocytes were fertilized (4.2 ± 1.7 vs 5.3 ± 2.4; p = .02). After surgery, we have registered also a better number of top-quality embryos (0.5 ± 0.6 vs 1.1 ± 0.9; p = .003). Pregnancy rate following the bariatric surgery increased to 15/40 (37.5%) (p < .001), and live birth rate (LBR) increased to 14/40 (35%) in the post-surgery group (p<. 001). CONCLUSIONS: Although additional research would be useful to draw definitive conclusion, our results appear to be encouraging enough to suggest the use of bariatric surgery in obese infertilewomen seeking an ART treatment.
Entities:
Keywords:
ART; Bariatric; IVF; Infertility; Obesity; Weight loss surgery
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