SOSA FERNANDEZ, LOREDANA MARIA (2021) Does bariatric surgery improve assisted reproductive technology outcomes in obese infertile patients? [Tesi di dottorato]

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Item Type: Tesi di dottorato
Lingua: English
Title: Does bariatric surgery improve assisted reproductive technology outcomes in obese infertile patients?
Creators:
CreatorsEmail
SOSA FERNANDEZ, LOREDANA MARIAloredana.sosafernandez@gmail.com
Date: 10 February 2021
Number of Pages: 34
Institution: Università degli Studi di Napoli Federico II
Department: Scienze Biomediche Avanzate
Dottorato: Scienze biomorfologiche e chirurgiche
Ciclo di dottorato: 32
Coordinatore del Corso di dottorato:
nomeemail
cuocolo, albertocuocolo@unina.it
Tutor:
nomeemail
Musella, MarioUNSPECIFIED
Date: 10 February 2021
Number of Pages: 34
Uncontrolled Keywords: infertility, bariatric surgery, art
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/18 - Chirurgia generale
Area 06 - Scienze mediche > MED/36 - Diagnostica per immagini e radioterapia
Area 06 - Scienze mediche > MED/40 - Ginecologia e ostetricia
Date Deposited: 22 Jan 2021 11:47
Last Modified: 28 Oct 2021 12:42
URI: http://www.fedoa.unina.it/id/eprint/13279

Abstract

Weight loss in overweight and obese women has been shown to increase natural conception rates and to improve the course of pregnancy, but there are very few studies investigating the impact of weight reduction in overweight and/or obese women prior to undergoing assisted reproductive technology (ART) treatment. It is rationale to hypothesise that these benefits would also be applicable to women who conceive via ART. Additionally, it is important to highlight that one increasingly common treatment option to obtain weight loss is bariatric surgery. In this setting, the benefits of bariatric surgery in improving fertility status have been well shown in the literature. However, data regarding the safety and efficacy of bariatric surgery on in vitro fertilization outcomes are still controversial. Prompted by the before-mentioned observations, we aimed to investigate the effect of bariatric surgery on ART outcomes. To better identify the impact of bariatric surgery on male and female infertile patients, we have separately analysed data about man and women undergoing ART treatment after bariatric surgery. We registered a significant decrease in the total number of gonadotropin units required and in the length of stimulation in IVF cycle following bariatric surgery, with an increase of the number of follicles ≥15 mm,of the number of retrieved oocytes, of the number of top-quality oocytes and of the number of MII oocytes.After surgery, we have registered 10 also a better number of top-quality embryos. The results showed an impressive high incidence (58%) of infertile women who become spontaneously pregnant after surgery. Based on these results, bariatric interventions could be included in the treatment of obesity-related infertility. We found a significant increase, after bariatric surgery, in semen volume, sperm concentration, total sperm concentration, motile sperm count and sperm morphology. Pregnancy rate significantly increased after bariatric surgery.

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