title: Does bariatric surgery improve ovarian stimulation characteristics, oocyte yield, or embryo quality?
abstract: BACKGROUND
  Obesity is a major global health concern associated with multiple co-morbidities. Bariatric surgery has been considered a good treatment option in cases of morbid obesity. This preliminary study aims to investigate the effect of bariatric surgery on ovarian stimulation characteristics and IVF treatment cycle outcome.
  
  
  METHODS
  A retrospective study that was performed in a tertiary, university-affiliated medical center and included all patients who underwent IVF treatment both before and after bariatric surgery. Data on ovarian stimulation variables of IVF treatment cycle prior and following the bariatric surgery were reviewed and compared.
  
  
  RESULTS
  From January 2005 to June 2014, seven women fulfilled the inclusion criteria. After the operation, BMI was significantly reduced (mean ± SD) (43.1 ± 3.3 vs. 29.6 ± 7.33, p = 0.018), as was the number of gonadotropin ampoules required during stimulation (69.3 ± 10.5 vs. 44.5 ± 17, p = 0.043). No between-cycle differences were observed in peak estradiol level, the number of oocytes retrieved, and percentage of mature oocytes.
  
  
  CONCLUSIONS
  To the best of our knowledge, this preliminary case series is the first comparison of IVF cycle characteristics prior to and following bariatric surgery. The operation seems to reduce treatment costs without affecting oocyte or embryo quality. Further large studies are required to establish the surgery's effect on IVF outcome among infertile women.
authors.affiliation: Infertility and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. avitsur@gmail.com.
authors.forename: Abraham
authors.initials: A
authors.lastname: Tsur
authors.affiliation: Infertility and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. raoul.orvieto@sheba.health.gov.il.
authors.forename: Raoul
authors.initials: R
authors.lastname: Orvieto
authors.affiliation: Infertility and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. jigalh@hotmail.com.
authors.forename: Jigal
authors.initials: J
authors.lastname: Haas
authors.affiliation: Infertility and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. kedem2001@gmail.com.
authors.forename: Alon
authors.initials: A
authors.lastname: Kedem
authors.affiliation: Infertility and In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel-Hashomer) and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Ronit.Machtinger@sheba.health.gov.il.
authors.forename: Ronit
authors.initials: R
authors.lastname: Machtinger
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology / Q000628:therapy*; D009765:Obesity / Q000601:surgery*; D009865:Oocytes / Q000502:physiology*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome