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Outcomes of in-vitro fertilization after bariatric surgery: a national register-based case–control study
Human Reproduction ( IF 6.1 ) Pub Date : 2022-07-29 , DOI: 10.1093/humrep/deac164
E Nilsson-Condori 1, 2, 3 , K Mattsson 2, 3 , A Thurin-Kjellberg 4 , J L Hedenbro 5 , B Friberg 3
Affiliation  

STUDY QUESTION Does previous bariatric surgery (BS) in women affect cumulative live birth rate in IVF? SUMMARY ANSWER Women having had BS seem to have the same cumulative live birth rate as non-operated women of the same BMI at IVF treatment. WHAT IS KNOWN ALREADY Because of the perinatal risks of obesity to mother and infant as well as impaired outcomes of IVF, obese women are advised to reduce their weight, but it is not clear whether previous BS could affect IVF results. STUDY DESIGN, SIZE, DURATION This national register-based case–control study included all cases of BS (n = 30 436) undergoing IVF (n = 153) from 2007 until 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Swedish women between 18 and 45 years operated with BS, with at least one first started cycle of IVF after surgery, were included. For each woman having IVF after BS (n = 153), up to five non-operated control women (n = 744) starting their first IVF cycle during the study period were matched for age, parity and BMI at treatment. The primary outcome in this study was the cumulative live birth rate (CLBR) after the first IVF cycle, defined as all live births after the first cycle including fresh and frozen embryo transfers. MAIN RESULTS AND THE ROLE OF CHANCE There was no significant difference in CLBR between the BS group and the matched controls (29.4% compared to 33.1%), even though the number of retrieved oocytes (7.6 vs 8.9, P = 0.005) and frozen embryos (1.0 vs 1.5, P = 0.041) were significantly fewer in the BS group. There was no association between cumulative live birth and BS, adjusted odds ratio 1.04, 95% CI (0.73, 1.51). However, the birth weight was significantly lower in the children born to mothers with previous BS, mean (SD) 3190 (690) vs 3478 (729) g, P = 0.037. LIMITATIONS, REASONS FOR CAUTION Confounders such as age, BMI and previous childbirth were accounted for by the matching design of the study, but there were no data on indication for IVF, anti-Müllerian hormone, smoking or previous comorbidities. The study was exploratory and did not reach sufficient power to detect potential smaller differences in live birth rates. WIDER IMPLICATIONS OF THE FINDINGS The findings concur with those in previously published smaller studies and provide somewhat reassuring results considering IVF outcomes after BS with a CLBR comparable to that of controls, despite a lower mean birth weight. STUDY FUNDING/COMPETING INTEREST(S) This research was funded by grants from the Southern Health Care Region of Sweden. The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A.

中文翻译:

减肥手术后体外受精的结果:一项基于国家登记的病例对照研究

研究问题 女性之前的减肥手术 (BS) 是否会影响 IVF 的累积活产率?总结答案 患有 BS 的女性在 IVF 治疗中的累积活产率似乎与具有相同 BMI 的非手术女性相同。已知情况 由于母婴肥胖的围产期风险以及 IVF 结局受损,建议肥胖女性减轻体重,但尚不清楚以前的 BS 是否会影响 IVF 结果。研究设包括 45 年的 BS 手术,手术后至少有一个首次开始的体外受精周期。对于每个在 BS 后接受 IVF 的女性(n = 153),在研究期间开始她们的第一个体外受精周期的多达五名非手术对照女性(n = 744)在治疗时的年龄、产次和BMI进行了匹配。本研究的主要结果是第一个 IVF 周期后的累积活产率 (CLBR),定义为第一个周期后的所有活产,包括新鲜和冷冻胚胎移植。主要结果和机会的作用 BS 组和匹配的对照组之间的 CLBR 没有显着差异(29.4% 对 33.1%),即使回收的卵母细胞数量(7.6 对 8.9,P = 0.005)和冷冻胚胎(1.0 对 1.5,P = 0.041)在 BS 组中显着减少。累积活产与 BS 之间没有关联,调整后的优势比 1.04, 95% CI (0.73, 1.51)。然而,先前患有 BS 的母亲所生的孩子的出生体重显着降低,平均 (SD) 3190 (690) 对 3478 (729) g,P = 0.037。限制、谨慎的原因 研究的匹配设计考虑了年龄、BMI 和既往分娩史等混杂因素,但没有关于 IVF、抗苗勒管激素、吸烟或既往合并症的适应症的数据。该研究是探索性的,并没有达到足够的能力来检测活产率的潜在较小差异。研究结果的更广泛意义 这些研究结果与先前发表的小型研究中的结果一致,并提供了一些令人放心的结果,考虑到 BS 后的体外受精结果,其 CLBR 与对照组相当,尽管平均出生体重较低。研究资助/竞争兴趣 本研究由瑞典南部医疗保健区资助。作者没有要声明的竞争利益。试用注册号 不适用。
更新日期:2022-07-29
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