Skip to main content
SpringerLink
Log in

Surgical Interventions and Reproductive Function in Obese Women

  • Chapter
Obesity and Fertility

  • 870 Accesses

Abstract

Surgical treatment options for obesity offer effective means for weight loss with meaningful reductions in obesity-related complications. For women who are morbidly obese with a body mass index ≥40 kg/m2, surgical weight loss intervention is the most reliable method for achievable and sustainable weight loss (Ann Intern Med. 142:532–46, 2005; Ann Intern Med. 142:547–59, 2005). As more and more women of childbearing age elect to undergo surgical intervention for obesity, information regarding the potential impact of bariatric surgery on fertility and pregnancy outcomes is important. Particularly since despite the benefits of bariatric surgery, it does have associated surgical and nutritional complications that may impact pregnancy. Furthermore, observations of fertility in women who have undergone bariatric procedures provide insight as to how obesity and weight loss impact reproductive physiology. This chapter seeks to elucidate and summarize the existing body of literature on the effect of surgical weight loss intervention on fertility and overall reproductive function in obese women.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. WHO. http://who.int/mediacentre/factsheets/fs311/en/

  2. Li Z, Maglione M, Tu W, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142:532–46.

    Article  CAS  PubMed  Google Scholar 

  3. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.

    Article  PubMed  Google Scholar 

  4. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149:275–87.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Vest AR, Heneghan HM, Agarwal S, Schauer PR, Young JB. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98:1763–77.

    Article  PubMed  Google Scholar 

  6. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300:2286–96.

    Article  CAS  PubMed  Google Scholar 

  7. Gosman GG, King WC, Schrope B, et al. Reproductive health of women electing bariatric surgery. Fertil Steril. 2010;94:1426–31.

    Article  PubMed Central  PubMed  Google Scholar 

  8. O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144:625–33.

    Article  PubMed  Google Scholar 

  9. Friedman D, Cuneo S, Valenzano M, et al. Pregnancies in an 18-year follow-up after biliopancreatic diversion. Obes Surg. 1995;5:308–13.

    Article  PubMed  Google Scholar 

  10. Marceau P, Kaufman D, Biron S, et al. Outcome of pregnancies after biliopancreatic diversion. Obes Surg. 2004;14:318–24.

    Article  PubMed  Google Scholar 

  11. Livingston EH. Obesity and its surgical management. Am J Surg. 2002;184:103–13.

    Article  PubMed  Google Scholar 

  12. Santoro N, Lasley B, McConnell D, et al. Body size and ethnicity are associated with menstrual cycle alterations in women in the early menopausal transition: the Study of Women’s Health across the Nation (SWAN) Daily Hormone Study. J Clin Endocrinol Metab. 2004;89:2622–31.

    Article  CAS  PubMed  Google Scholar 

  13. Jain A, Polotsky AJ, Rochester D, et al. Pulsatile luteinizing hormone amplitude and progesterone metabolite excretion are reduced in obese women. J Clin Endocrinol Metab. 2007;92:2468–73.

    Article  CAS  PubMed  Google Scholar 

  14. Gosman GG, Katcher HI, Legro RS. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update. 2006;12:585–601.

    Article  CAS  PubMed  Google Scholar 

  15. Michalakis KG, Segars JH. The role of adiponectin in reproduction: from polycystic ovary syndrome to assisted reproduction. Fertil Steril. 2010;94:1949–57.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Brannian JD, Zhao Y, McElroy M. Leptin inhibits gonadotrophin-stimulated granulosa cell progesterone production by antagonizing insulin action. Hum Reprod. 1999;14:1445–8.

    Article  CAS  PubMed  Google Scholar 

  17. Welt CK, Chan JL, Bullen J, et al. Recombinant human leptin in women with hypothalamic amenorrhea. N Engl J Med. 2004;351:987–97.

    Article  CAS  PubMed  Google Scholar 

  18. Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril. 2008;89:899–906.

    Article  PubMed  Google Scholar 

  19. Shah DK, Ginsburg ES. Bariatric surgery and fertility. Curr Opin Obstet Gynecol. 2010;22:248–54.

    Article  PubMed  Google Scholar 

  20. Tortoriello DV, McMinn J, Chua SC. Dietary-induced obesity and hypothalamic infertility in female DBA/2J mice. Endocrinology. 2004;145:1238–47.

    Article  CAS  PubMed  Google Scholar 

  21. Tortoriello DV, McMinn JE, Chua SC. Increased expression of hypothalamic leptin receptor and adiponectin accompany resistance to dietary-induced obesity and infertility in female C57BL/6J mice. Int J Obes (Lond). 2007;31:395–402.

    Article  CAS  Google Scholar 

  22. Terra X, Auguet T, Guiu-Jurado E, et al. Long-term changes in leptin, chemerin and ghrelin levels following different bariatric surgery procedures: Roux-en-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2013;23:1790–8.

    Article  PubMed  Google Scholar 

  23. Uzun H, Zengin K, Taskin M, Aydin S, Simsek G, Dariyerli N. Changes in leptin, plasminogen activator factor and oxidative stress in morbidly obese patients following open and laparoscopic Swedish adjustable gastric banding. Obes Surg. 2004;14:659–65.

    Article  PubMed  Google Scholar 

  24. Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.

    Article  PubMed  Google Scholar 

  25. Sharpe RM, Franks S. Environment, lifestyle and infertility—an inter-generational issue. Nat Cell Biol. 2002;4(Suppl):s33–40.

    Article  PubMed  Google Scholar 

  26. Jamal M, Gunay Y, Capper A, Eid A, Heitshusen D, Samuel I. Roux-en-Y gastric bypass ameliorates polycystic ovary syndrome and dramatically improves conception rates: a 9-year analysis. Surg Obes Relat Dis. 2012;8:440–4.

    Article  PubMed  Google Scholar 

  27. Eid GM, Cottam DR, Velcu LM, et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1:77–80.

    Article  PubMed  Google Scholar 

  28. Legro RS, Dodson WC, Gnatuk CL, et al. Effects of gastric bypass surgery on female reproductive function. J Clin Endocrinol Metab. 2012;97:4540–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Musella M, Milone M, Bellini M, Sosa Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Relat Dis. 2012;8(4):445–9.

    Article  PubMed  Google Scholar 

  30. Doblado MA, Lewkowksi BM, Odem RR, Jungheim ES. In vitro fertilization after bariatric surgery. Fertil Steril. 2010;94:2812–4.

    Article  PubMed Central  PubMed  Google Scholar 

  31. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol. 2009;113:1405–13.

    Article  Google Scholar 

  32. Sheiner E, Edri A, Balaban E, Levi I, Aricha-Tamir B. Pregnancy outcome of patients who conceive during or after the first year following bariatric surgery. Am J Obstet Gynecol. 2011;204:50.e1–6.

    Article  Google Scholar 

  33. Dao T, Kuhn J, Ehmer D, Fisher T, McCarty T. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192:762–6.

    Article  PubMed  Google Scholar 

  34. Roos N, Neovius M, Cnattingius S, et al. Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study. BMJ. 2013;347:f6460.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Kjaer MM, Lauenborg J, Breum BM, Nilas L. The risk of adverse pregnancy outcome after bariatric surgery: a nationwide register-based matched cohort study. Am J Obstet Gynecol. 2013;208:464.e1–5.

    Article  Google Scholar 

  36. Aricha-Tamir B, Weintraub AY, Levi I, Sheiner E. Downsizing pregnancy complications: a study of paired pregnancy outcomes before and after bariatric surgery. Surg Obes Relat Dis. 2012;8:434–9.

    Article  PubMed  Google Scholar 

  37. Amsalem D, Aricha-Tamir B, Levi I, Shai D, Sheiner E. Obstetric outcomes after restrictive bariatric surgery: what happens after 2 consecutive pregnancies? Surg Obes Relat Dis. 2014;10:445–9.

    Article  PubMed  Google Scholar 

  38. Facchiano E, Iannelli A, Santulli P, Mandelbrot L, Msika S. Pregnancy after laparoscopic bariatric surgery: comparative study of adjustable gastric banding and Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2012;8:429–33.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA

    Julie S. Rhee MD

  2. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Jason Y. Rhee MD, MPHS

Authors
  1. Julie S. Rhee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason Y. Rhee MD, MPHS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julie S. Rhee MD .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA

    Emily S. Jungheim

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Rhee, J.S., Rhee, J.Y. (2015). Surgical Interventions and Reproductive Function in Obese Women. In: Jungheim, E. (eds) Obesity and Fertility. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2611-4_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2611-4_12

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2610-7

  • Online ISBN: 978-1-4939-2611-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation