The role of bariatric surgery in enhancing IVF outcomes for obese women: A systematic review protocol

This systematic review protocol lays the foundation for the systematic review, which aims to assess the impact of bariatric surgery on IVF outcomes, particularly cumulative live birth rates, in obese women. Obesity contributes to infertility through hormonal imbalances, metabolic dysfunctions, and ovulatory irregularities. Bariatric surgery has been proposed to enhance reproductive outcomes by inducing significant weight loss. However, in those who require early IVF, risks may outweigh benefits, as the waiting period between surgery and IVF may affect their ovarian reserve, reducing success rates. The study protocol follows PRISMA guidelines and will include randomised controlled trials and observational studies evaluating IVF success post-surgery. Primary outcomes that will be studied will include cumulative live birth rates, while secondary outcomes examine pregnancy rates, gonadotropin doses, cycle cancellation, ovarian reserve markers, and implantation rates. The summary statistics represented by odds ratio for the meta-analysis will be calculated using a random-effects model. Heterogeneity will be assessed using I² statistics, and subgroup analyses may be done if more low to moderate risk-of-bias studies are found. Findings from this study will provide evidence-based insights into the effectiveness of bariatric surgery as a pre-IVF intervention, aiding clinicians in optimising fertility treatment strategies for obese women.