减重手术对辅助生殖技术结局的影响：系统评价方案。
The impact of bariatric surgery on assisted reproductive technology outcomes: a systematic review protocol.
机构信息
Faculty of Medicine, University of Ottawa, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
出版信息
Syst Rev. 2022 Jan 3;11(1):1. doi: 10.1186/s13643-021-01870-8.
BACKGROUND
Individuals with obesity are at higher risk of experiencing complications during their pregnancy and may also experience infertility, requiring assisted reproductive technologies (ART) to conceive. The current body of literature demonstrates that bariatric surgery decreases an individual's risk of developing a variety of obesity-related obstetrical conditions during and after pregnancy. However, the effects of bariatric surgery on ART outcomes are not well understood. Therefore, the paucity in the literature warrants a need to determine these effects.
METHODS
We will search electronic databases, including MEDLINE, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL), as well as the gray literature and the reference lists of included articles. We will screen all studies published between January 1978 and the present day that explore the impact of bariatric surgery on ART outcomes for women and men. We will include observational studies. Two independent reviewers will assess the studies for inclusion and extract data for each article. The main outcome that will be analyzed is live birth rate. Secondary outcomes such as time to conception, number of rounds of ART, type of bariatric surgery, and length of time between bariatric surgery and initiation of ART will also be recorded. Risk of bias will be conducted using the National Institutes of Health Study Quality Assessment Tools. A random effects model will be used to account for statistical analysis and results will be pooled with forest plots. In the event of statistical and reporting heterogeneity, we will provide a qualitative synthesis and narrative review of the results.
DISCUSSION
This review will provide information on the outcomes of ART following bariatric surgery and may help healthcare professionals make informed decisions about the length of time between bariatric surgery and initiation of ART. The study findings may be of interest to various stakeholders including patients, bariatric surgeons, obstetricians, and gynecologists, and those who specialize in obesity medicine and reproductive endocrinology and infertility. We plan to disseminate our findings through presentations, publications, and social media releases to individuals who are navigating infertility and are interested in undergoing or have undergone bariatric surgery, healthcare professionals, policymakers, and researchers.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42021252561.
背景
肥胖个体在妊娠期间出现并发症的风险较高，并且可能还患有不孕症，需要辅助生殖技术 (ART) 来受孕。目前的文献表明，减重手术可降低个体在妊娠期间和之后发生多种肥胖相关产科疾病的风险。然而，减重手术对 ART 结局的影响尚不清楚。因此，文献中的不足需要确定这些影响。
方法
我们将检索电子数据库，包括 MEDLINE、Embase、Scopus 和 Cochrane 中央对照试验注册库 (CENTRAL)，以及灰色文献和纳入文章的参考文献列表。我们将筛选所有发表于 1978 年 1 月至今日的研究，探讨减重手术对女性和男性 ART 结局的影响。我们将纳入观察性研究。两名独立评审员将评估研究纳入情况并提取每篇文章的数据。主要结局分析是活产率。次要结局包括受孕时间、ART 轮数、减重手术类型和减重手术与开始 ART 之间的时间长度。将使用美国国立卫生研究院研究质量评估工具进行偏倚风险评估。将使用随机效应模型进行统计分析并汇总森林图。如果存在统计学和报告上的异质性，我们将提供结果的定性综合和叙述性综述。
讨论
本综述将提供关于减重手术后 ART 结局的信息，这可能有助于医疗保健专业人员在减重手术和开始 ART 之间的时间长度方面做出明智的决策。研究结果可能会引起各种利益相关者的兴趣，包括正在经历不孕症并有意接受或已接受减重手术的患者、减重外科医生、妇产科医生、以及专门从事肥胖医学和生殖内分泌学与不孕症的医生。我们计划通过演讲、出版物和社交媒体发布将研究结果传播给正在经历不孕症并有意接受或已接受减重手术的个人、医疗保健专业人员、政策制定者和研究人员。
系统评价注册
PROSPERO CRD42021252561。
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