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Reproductive Outcomes Differ Following Roux-en-Y Gastric Bypass and Adjustable Gastric Band Compared with Those of an Obese Non-Surgical Group

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Abstract

Background

Little is known about how bariatric surgery type may impact reproductive health outcomes. Our objective was to determine differences in infertility and birth outcomes among women who underwent Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), and an obese non-surgical group.

Methods

Women aged 18–45 who were evaluated for bariatric surgery were invited to complete a survey. Pre- and post-surgery outcomes were compared among women who underwent RYGB vs. AGB and to those of obese women who decided against surgery. Outcomes included infertility, time to conception from first attempt, use of infertility services, pregnancy, live birth, and birth weights. Logistic and linear regression, controlling for age, BMI, weight, and pregnancy history, were used to calculate odds ratios (ORs) and beta-coefficients with 95 % confidence intervals (CIs).

Results

Two-hundred nineteen surveys were completed. RYGB resulted in a reduction in menstrual cycle irregularity after surgery compared to before (OR = 0.21, CI = 0.07–0.61). For first-pregnancy outcomes, there were lower odds of term birth after RYGB than before (OR = 0.21, CI = 0.05–0.90) and increased odds of miscarriage after RYGB compared to the no-surgery group (OR = 9.81, CI = 1.12–85.71). We found lower odds of live birth after AGB than before (OR = 0.19, CI = 0.05–0.73). Birth weight was significantly lower after RYGB but not AGB (p < 0.01).

Conclusions

This small study suggests that the impact of bariatric surgery may vary by procedure type and impact menstrual regularity, live birth, and offspring birth weight. These results should be considered pilot data and support performance of a prospective study to fully investigate these preliminary findings.

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Acknowledgments

LF was supported by T32HD060454 in reproductive, perinatal, and pediatric epidemiology from the Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institute of Health.

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Authors and Affiliations

  1. Department of Obstetrics, Center for Infertility and Reproductive Surgery, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Randi H. Goldman, Stacey A. Missmer, Leslie V. Farland & Elizabeth S. Ginsburg

  2. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Stacey A. Missmer & Leslie V. Farland

  3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Stacey A. Missmer

  4. Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Malcolm K. Robinson

Authors
  1. Randi H. Goldman
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  2. Stacey A. Missmer
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  3. Malcolm K. Robinson
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  4. Leslie V. Farland
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  5. Elizabeth S. Ginsburg
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Corresponding author

Correspondence to Randi H. Goldman.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Author EG has received a research grant from Serono, as well as royalties from Up-To-Date that are outside of the submitted work. Authors RG, SM, MR, and LF declare that they have no conflicts of interest.

Funding

This study was funded by an intramural grant from the Department of Obstetrics and Gynecology at Brigham and Women’s Hospital.

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Goldman, R.H., Missmer, S.A., Robinson, M.K. et al. Reproductive Outcomes Differ Following Roux-en-Y Gastric Bypass and Adjustable Gastric Band Compared with Those of an Obese Non-Surgical Group. OBES SURG 26, 2581–2589 (2016). https://doi.org/10.1007/s11695-016-2158-4

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  • DOI: https://doi.org/10.1007/s11695-016-2158-4

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