Milone Marco, Sosa Fernandez Loredana M, Sosa Fernandez Laura V, Manigrasso Michele, Elmore Ugo, De Palma Giovanni D, Musella Mario, Milone Francesco
Department of Surgical Specialities and Nephrology, University of Naples "Federico II", Via Pansini 5, 80131, Naples, Italy.
Embryos Fertility Center, Battipaglia, Salerno, Italy.
Obes Surg. 2017 Aug;27(8):2106-2112. doi: 10.1007/s11695-017-2614-9.
Little is known about the impact of bariatric surgery on obese infertile women seeking an assisted reproductive technology.
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.
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).
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.
关于减肥手术对寻求辅助生殖技术的肥胖不孕女性的影响，目前所知甚少。
纳入所有有辅助生殖技术（ART）失败史且在减肥手术前后均接受ART治疗周期的肥胖女性。比较ART结局，评估使用促性腺激素的持续时间和剂量；第3天促卵泡生成素（FSH）的测量值；抗苗勒管激素剂量；直径>15mm的卵泡数量；获取的卵母细胞和受精的卵母细胞数量；中期II、中期I和生发泡期卵母细胞数量；获得的胚胎数量；优质卵母细胞和胚胎数量；移植胚胎数量；妊娠率和活产率。
纳入40名女性。减肥手术后所需促性腺激素单位总数及刺激时间减少（p = 0.001），直径≥15mm的卵泡数量（p = 0.005）、获取的卵母细胞数量（p = 0.004）、优质卵母细胞数量（p = 0.001）和中期II卵母细胞数量（p = 0.008）增加。受精的卵母细胞更多（4.2±1.7 vs 5.3±2.4；p = 0.02）。手术后，优质胚胎数量也有所增加（0.5±0.6 vs 1.1±0.9；p = 0.003）。减肥手术后妊娠率升至15/40（37.5%）（p < 0.001），术后组活产率（LBR）升至14/40（35%）（p < 0.001）。
尽管需要更多研究才能得出明确结论，但我们的结果似乎足以令人鼓舞，表明减肥手术可用于寻求ART治疗的肥胖不孕女性。
