Impact of Bariatric Surgery on Female Reproductive Health and Maternal Outcomes

Obes Surg. 2020 Feb;30(2):383-390. doi: 10.1007/s11695-019-04245-0.

Abstract

Introduction: Obesity has a derogatory effect on female reproductive health. Obesity contributes to difficulty in natural conception, increased risk of pregnancy-associated complications, miscarriages, congenital anomalies, and also the long-term negative impact on both mother and the child.

Objectives: Our study aimed to analyze and assess the reproductive health-associated outcomes of females who underwent bariatric surgery.

Methods: We performed a retrospective analysis from a prospectively collected database from June 2013 to June2016. Out of 71 females studied, 45 patients (63.5%) had completed 3 years of follow-up. The data were collected from inpatient and outpatient records. Patients were studied under three groups (A, patients with polycystic ovarian disease (PCOD) symptoms; B, patients with primary infertility; and C, patients who conceived after bariatric surgery that were included in groups A and B).

Results: Out of 45 patients studied, 40 patients underwent laparoscopic sleeve gastrectomy (LSG), four patients underwent laparoscopic Roux-en-Y gastric bypass (RYGB), and one patient underwent laparoscopic adjustable gastric banding (LAGB). The mean BMI of the patients was 43.64 ± 6.8 kg/m2. PCOD symptoms improved symptomatically (p = 0.001) after surgery in the group. Seven (43.75%) primary infertility patients conceived after surgery. Three (42.9%) patients conceived naturally while 4 (57.1%) conceived with ART in group B. Out of total population of 45 in group C, percentages of patients who delivered baby with short gestational age (SGA), low birth weight (LBW), normal vaginal deliveries (NVD), and maternal anemia were 63.15%,47.3%,73.4%, and26.3%, respectively.

Conclusion: Obesity is closely associated with primary infertility and PCOD. Menstrual abnormalities associated with PCOD significantly improve after bariatric surgery with significant improvement in fertility along with maternal outcomes.

Keywords: ART, assisted reproductive technique; BS; LSG, laparoscopic sleeve gastrectomy; Low birth weight; PCOD; RYGB, Roux-en-Y gastric bypass; Small for gestational age; bariatric surgery.

MeSH terms

  • Adolescent
  • Adult
  • Bariatric Surgery* / statistics & numerical data
  • Databases, Factual
  • Female
  • Humans
  • Infertility, Female / complications
  • Infertility, Female / epidemiology
  • Infertility, Female / surgery
  • Laparoscopy / statistics & numerical data
  • Male
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery*
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / epidemiology
  • Polycystic Ovary Syndrome / surgery
  • Preconception Care / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Reproduction / physiology*
  • Reproductive Health
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss / physiology*
  • Young Adult