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Sleeve Gastrectomy for Obesity in Polycystic Ovarian Syndrome: a Pilot Study Evaluating Weight Loss and Fertility Outcomes

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Abstract

Purpose

Polycystic ovarian syndrome (PCOS) is a common endocrine disorder associated with obesity and infertility. Gastric bypass has been shown to be effective in treating these symptoms. However, the efficacy of vertical sleeve gastrectomy (VSG) has not been studied in the PCOS population. This study analyzed weight loss and fertility outcomes of VSG in this population.

Methods

A retrospective review of patients with PCOS and without PCOS (CON) undergoing VSG from 2008 to 2016 was performed at two bariatric centers. BMI and percent excess weight loss (%EWL) were collected at 3, 6, and 12 months postoperatively. Patient characteristics and postoperative pregnancy status were compared between the two cohorts.

Results

One hundred nineteen PCOS patients were compared to 119 CON patients. Similar attrition rates were seen between cohorts at 3-month (5 vs 8%), 6-month (13 vs. 14%), and 12-month (18 vs. 13%) evaluation. PCOS patients had greater ΔBMI at 3 months (− 7.64 vs. − 6.82; p = 0.05), 6 months (− 10.56 vs. − 9.49; p = 0.02), and 12 months (− 12.43 vs. − 11.49; p = 0.04). PCOS patients also had greater %EWL at 12 months compared to CON (66 vs 60%; p = 0.05). Twenty-two percent of PCOS patients became pregnant within 12 months, 69% of which were previously nulliparous.

Conclusion

Compared to non-PCOS patients, PCOS patients had greater postoperative ΔBMI and %EWL at 1 year. The majority of patients becoming pregnant after VSG were previously nulliparous. This study shows that VSG is effective for weight loss in PCOS patients with obesity and may positively augment effect fertility rates.

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References

  1. 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(2):77–80.

    Article  PubMed  Google Scholar 

  2. Lim SS, Davies MJ, Norman RJ, et al. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.

    Article  CAS  PubMed  Google Scholar 

  3. Wang K, Jiang Q, Zhi Y, et al. Contrasting sleeve gastrectomy with lifestyle modification therapy in the treatment of polycystic ovary syndrome. J Laparoendosc Adv Surg Tech. 2015;25(6):493–8.

    Article  Google Scholar 

  4. Chen X, Jia X, Qiao J, et al. Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome. J Mol Endocrinol. 2013;50(2):R21–37.

    Article  CAS  PubMed  Google Scholar 

  5. Escobar-Morreale HF, Botella-Carretero JI, Álvarez-Blasco F, et al. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90(12):6364–9.

    Article  CAS  PubMed  Google Scholar 

  6. Ressler IB, Grayson BE, Seeley RJ. Metabolic, behavioral, and reproductive effects of vertical sleeve gastrectomy in an obese rat model of polycystic ovary syndrome. Obes Surg. 2014;24(6):866–76.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Wilson-Pérez HE, Seeley RJ. The effect of vertical sleeve gastrectomy on a rat model of polycystic ovarian syndrome. Endocrinology. 2011;152(10):3700–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  9. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.

    Article  PubMed  Google Scholar 

  10. Lemus R, Karni D, Hong D, et al. The impact of bariatric surgery on insulin-treated type 2 diabetes patients. Surg Endosc. 2017;25:1–12.

    Google Scholar 

  11. Scinta W. Measuring success: a comparison of weight loss calculations. Bariatric Times. 2012;9(7):18–20.

    Google Scholar 

  12. Sjostrom L, Nabro K, Sjostrom CD, et al. Swedish obese subjects study: effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.

    Article  PubMed  Google Scholar 

  13. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity, 2013:1(21)

  14. Osland E, Yunus RM, Khan S, et al. Weight loss outcomes in laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic roux-en-Y gastric bypass (LRYGB) procedures: a meta-analysis and systematic review of randomized controlled trials. Surg Laparosc Endosc Percutan Tech. 2017;27(1):8–18.

    PubMed  Google Scholar 

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Authors and Affiliations

Authors

Contributions

Study design and development: Dilday, Ahnfeldt, Sanders, Bader.

Data collection: Dilday, Derickson, Kuckelman.

Data analysis: Dilday, Derickson, Kuckelman, Reitz, Ahnfeldt, Martin, Sanders.

Manuscript writing: Dilday, Derickson, Kuckelman, Reitz, Martin, Sanders.

Critical revisions: Dilday, Derickson, Kuckelman, Ahnfeldt, Martin, Sanders.

Corresponding author

Correspondence to Joshua Dilday.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

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Does not apply.

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Dilday, J., Derickson, M., Kuckelman, J. et al. Sleeve Gastrectomy for Obesity in Polycystic Ovarian Syndrome: a Pilot Study Evaluating Weight Loss and Fertility Outcomes. OBES SURG 29, 93–98 (2019). https://doi.org/10.1007/s11695-018-3473-8

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  • DOI: https://doi.org/10.1007/s11695-018-3473-8

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