减肥手术后的体重反弹与体外受精结局

Weight Regain following Bariatric Surgery and in vitro Fertilization Outcomes.

作者信息

Zemer-Tov Bar, Ziv-Baran Tomer, Igawa May, Lieberman Gabriella, Orvieto Raoul, Machtinger Ronit

机构信息

Infertility and IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel and Faculty of Medicine and Health Science, Tel- Aviv University, Tel Aviv, Israel.

Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel.

出版信息

Obes Facts. 2024;17(6):593-601. doi: 10.1159/000540388. Epub 2024 Aug 13.

DOI:10.1159/000540388

PMID:39047705

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661842/

Abstract

INTRODUCTION

The aim of this study was to estimate the time to pregnancy and live birth and evaluate the effect of weight regain in women with a history of bariatric surgery (BS) who underwent in vitro fertilization (IVF) treatments.

METHODS

This is a retrospective cohort study. All patients with previous BS who underwent IVF treatment in a tertiary university-affiliated hospital between 2013 and 2022 were included. Time to pregnancy and live birth were compared between patients who regained less than or greater than three points of body mass index (BMI) from the nadir weight after BS. Kaplan-Meier curves and log-rank tests were used to compare groups.

RESULTS

A total of 78 patients were included in this study. The positive β-hCG, clinical pregnancy, and live birth rates following BS were 89.4%, 78.9%, and 50.8%, respectively. The median time from the beginning of IVF treatments to a positive β-hCG test was 2.97 months (95% CI: 1.04-4.89 months), to a clinical pregnancy was 7.1 months (95% CI: 3.56-10.91), and to a live birth was 20.2 months. Women who maintained their nadir BMI following BS had nearly twice the chance of achieving a clinical pregnancy (HR 1.967, 95% CI: 1.026-3.771, p = 0.042) and were approximately three times more likely to achieve a live birth (2.864, 95% CI: 1.196-6.859, p = 0.018) than those who regained at least three points of BMI.

CONCLUSION

Weight regain after BS is associated with a lower rate of live births and prolonged time to achieve clinical pregnancy and live birth.

摘要

引言

本研究的目的是估计接受过减肥手术（BS）的女性进行体外受精（IVF）治疗后的受孕时间和活产时间，并评估体重恢复的影响。

方法

这是一项回顾性队列研究。纳入了2013年至2022年间在一所大学附属三级医院接受IVF治疗且既往有BS史的所有患者。比较了BS后体重指数（BMI）从最低点恢复不足或超过三分的患者的受孕时间和活产时间。采用Kaplan-Meier曲线和对数秩检验进行组间比较。

结果

本研究共纳入78例患者。BS后的β-hCG阳性率、临床妊娠率和活产率分别为89.4%、78.9%和50.8%。从IVF治疗开始到β-hCG检测阳性的中位时间为2.97个月（95%CI：1.04 - 4.89个月），到临床妊娠为7.1个月（95%CI：3.56 - 10.91个月），到活产为20.2个月。BS后维持最低BMI的女性实现临床妊娠的几率几乎是BMI至少恢复三分的女性的两倍（HR 1.967，95%CI：1.026 - 3.771，p = 0.042），实现活产的可能性约为后者的三倍（2.864，95%CI：1.196 - 6.859，p = 0.018）。