Does Bariatric Surgery Improve Assisted Reproductive Technology Outcomes in Obese Infertile Women?

Milone, Marco; Fernandez, Loredana Maria Sosa; Fernandez, Laura Virginia Sosa; Manigrasso, Michele; Elmore, Ugo; Palma, Giovanni Domenico De; Musella, Mario; Milone, Francesco

doi:10.1007/s11695-017-2614-9

Cited by 51 publications

(42 citation statements)

References 29 publications

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“…The Andersen model (of predisposing, enabling and need factors) may be used to aid our interpretation of these patterns. The higher uptake among females that was found in other studies [13,14] and echoed here, for example, may relate to gender differences in predisposing factors that are associated with reproduction [28] or social norms around the perception of obesity that tend to be particularly acute for females [29]. Similarly, the differences in uptake between eligible Blacks and Whites that were observed in this study and that have been related previously to insurance status [16] may be interpreted as an enabling factor, while ACCI or the presence of specific conditions may be interpretable in terms of need.…”

Section: Discussionsupporting

confidence: 79%

Ethnic Disparities in Use of Bariatric Surgery in the USA: the Experience of Native Americans

et al. 2020

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Purpose To examine disparities in use of bariatric surgery in the USA with particular focus on the experience of Native Americans. Materials and Methods Multivariable logistic regression models were applied to the hospital discharge HCUP-NIS dataset (2008–2016) in order to examine the influence of ethnicity in use of bariatric surgery while controlling for aspects of need, predisposing and enabling factors. Separate models investigated disparities in length of stay, cost and discharge to healthcare facility among patient episodes for bariatric surgery. Results Full data for 1,729,245 bariatric surgery eligible participants were extracted from HCUP-NIS. The odds of Native Americans receiving bariatric surgery compared to White Americans were 0.67 (95% CI, 0.62–0.73) in a model unadjusted for covariates; 0.65 (95% CI, 0.59–0.71) in a model adjusted for demography and insurance; 0.59 (95% CI, 0.54–0.64) in a model adjusted for clinical variables; and 0.72 (95% CI, 0.66–0.79) in a model adjusted for demographic, insurance types and clinical variables. Native Americans who underwent surgery had significantly shorter lengths of stay, lower healthcare expenditures and lower likelihood of discharge to other healthcare facilities relative to White Americans (controlling for covariates). Conclusion Our study, the first study to examine this subject, showed apparent variations in receipt of bariatric surgery between Native Americans and White Americans even after a range of covariates were controlled. In addition, Native Americans have shorter lengths of stay and significantly lower expenditures.

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Section: Discussionsupporting

confidence: 79%

Ethnic Disparities in Use of Bariatric Surgery in the USA: the Experience of Native Americans

et al. 2020

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“…So, AMH decrease in patients with PCOS is possibly a sign of clinical improvement [24]. A recent study by Milone et al suggested improved assisted reproductive technology (ART) outcomes after BS in terms of oocyte number and quality and found no significant post-operative variations in AMH levels [25]. However, inversely, some studies have reported decreased AMH concentrations after bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women

Vincentelli

Maraninchi

Valéro

et al. 2018

J Assist Reprod Genet

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“…A retrospective study aiming to evaluate the ART outcomes in 40 infertile obese women before and after bariatric surgery, showed an increase in the number of retrieved oocytes (6.6 ± 1.7 vs. 8.1 ± 2.5, p = 0.004), MII oocytes (5.5 ± 1.6 vs. 6.9 ± 2.8, p = 0.008) and fertilized oocytes (4.2 ± 1.7 vs. 5.3 ± 2.4, p = 0.02). Moreover, pregnancy rates increased by 37.5% (p < 0.001) and live birth rates by 35% (p < 0.001) following bariatric surgery [68].…”

Section: Obesity and Female Infertility (Interventional Studies)mentioning

confidence: 99%

Vitamin D and Obesity: Two Interacting Players in the Field of Infertility

et al. 2019

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Obesity plays an important role in human fertility in both genders. The same is true for vitamin D, for which accumulating evidence from observational human studies suggests a key role for both male and female fertility. In the latter case, however, robust data from relevant interventional studies are currently lacking. It is also not clear whether obesity and vitamin D deficiency, besides their independent effect on human infertility, act in synergy. Several pathogenetic mechanisms may be proposed as a linkage between vitamin D deficiency and obesity, with respect to infertility. In any case, the independent contribution of vitamin D deficiency in obese infertile states needs to be proven in interventional studies focusing on either vitamin D supplementation in obese or weight loss strategies in vitamin D-deficient infertile patients.

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Does Bariatric Surgery Improve Assisted Reproductive Technology Outcomes in Obese Infertile Women?

Abstract: 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.

Cited by 51 publications

References 29 publications

Ethnic Disparities in Use of Bariatric Surgery in the USA: the Experience of Native Americans

Ethnic Disparities in Use of Bariatric Surgery in the USA: the Experience of Native Americans

One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women

Vitamin D and Obesity: Two Interacting Players in the Field of Infertility

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