FOLLICLE FLUSHING DOES NOT IMPROVE LIVE BIRTH AND REDUCES OOCYTE YIELD: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS (RCTs)

Abstract

RESULTS: Forty-five eligible patients underwent 151 cycles (median: 2.0, interquartile range [IQR]: 1.0-4.0). Eighty-percent of patients had undergone gastric bypass, 7 (15.5%) had undergone gastric banding, and 2 (4.4%) had undergone a gastric sleeve procedure. At the start of their first cycle, median age was 38.6 years (IQR: 35.9-40.8), and median BMI was 33.6 (IQR: 29.0-39.3). At the time of the first IVF cycle, the median time since surgery was 3.9 years (IQR: 2.0-7.2), and the median weight loss was 100.0 pounds (IQR: 70.0-137.5). Among all cycles, pregnancy was achieved in 55 (36.4%), with 35 of 45 (77.8%) patients achieving at least one pregnancy, and 27 (17.9%) resulted in live birth, with 20 patients (44.4%) achieving at least one live birth. Of the 55 pregnancies, there were 16 (29.1%) biochemical pregnancies, 9 (16.4%) miscarriages, and 3 (5.5%) ectopic pregnancies. Of those who were known to be anovulatory prior to surgery (n¼18), 27.8% regained ovulatory function following surgery. Pregnancies were similar between people who lost <100 pounds (n¼13; 14 pregnancies among 43 cycles [32.6%]) and those who lost R100 pounds (n¼23; 28 pregnancies among 80 cycles [35.0%]). Among all cycles, compared to people who lost <100 pounds, people who lost R100 pounds were less likely to experience biochemical pregnancy (21.4% vs. 28.6%, respectively) and miscarriage (10.7% vs. 21.4%, respectively) and more likely to experience ectopic pregnancy (10.7% vs. 0%, respectively) and live birth (57.1% vs. 50.0%).CONCLUSIONS: At our center, patients who have undergone bariatric surgery prior to infertility treatment had favorable IVF outcomes. Our existing cohort is currently being expanded to allow for more robust analysis of outcomes with regards whether the type of surgery, timing of surgery relative to IVF, or absence or presence of comorbidities impacts IVF outcome.