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Surgery and fertility

Bariatric surgery does not affect oocyte or embryo quality

Credit: tipstimes.com/pregnancy
To date, few reports have described treatment outcomes of infertile female patients undergoing IVF following bariatric surgery
The researchers collected data on patient age, BMI, and variables related to infertility treatment

Preliminary research examining whether weight reduction through bariatric surgery can be beneficial treatment option for morbidly obese infertile patients has concluded that surgery seems to reduce treatment costs without affecting oocyte or embryo quality. However, the researchers from the Chaim Sheba Medical Center, Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Israel, said that further large studies are required to establish the surgery’s effect on IVF outcome among infertile women.

“To the best of our knowledge, this is the first comparison of IVF cycle characteristics prior to and following bariatric surgery,” write the authors. “To date, few reports have described treatment outcomes of infertile female patients undergoing IVF following bariatric surgery.”

The study, published in the Journal of Ovarian Research, examined the effect of bariatric surgery on ovarian stimulation characteristics and IVF treatment cycle outcome in infertile patients undergoing IVF treatment, both prior to and following bariatric surgery.

Seven patients were included in the study, all had undergone an IVF treatment cycle both before and after bariatric surgery. The researchers collected data on patient age, BMI, and variables related to infertility treatment were collected from the files. In addition, ovarian stimulation characteristics, number of oocytes retrieved, embryo quality, and number of embryos transferred during the patients’ IVF cycles before and after bariatric surgery were compared.

The reasons for IVF included male factor infertility (n=2), PCOS (n=2), genetic (n=1), unexplained (n=1) and age (n=1). Mean ± SD intervals between the operation and the subsequent IVF treatment cycle and between the consecutive IVF cycles were 15.6 ± 7.9 months and 28.4 ± 29.0 months, respectively.

Five patients underwent sleeve gastrectomy and two gastric banding. All the patients had their weight stabilised before starting the IVF treatment, as the metabolic parameters vary widely during the rapid weight-loss phase after the surgery. After surgery, BMI was significantly reduced (43.1 ± 3.3 vs. 29.6 ± 7.33, p=0.018) and two women were found to have their severe co-morbidities (diabetes and hypertension) completely resolved without any additional treatment. However, two were overweight and three remained obese (of them two remained morbid obese).

Following the surgery, patients required significantly fewer gonadotropin ampoules. There were no differences between the cycles in peak estradiol level, number of follicles ≥15mm on day of hCG administration, the number of oocytes retrieved, MII oocytes, fertilization rates or number of TQE.

One of the patients conceived from embryos cryopreserved in the cycle following the operation. This pregnancy ended in missed abortion in the first trimester. The other patients did not conceive in the first cycle after the surgery.

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