Bariatric Surgery

Abstract

Obesity is a leading cause of infertility in both males and females. For those attempting to conceive, weight loss is often the most fundamental and simple form of treatment for difficulty in conception, but can often be one of the most difficult to do without assistance. Weight loss is known to decrease circulating androgens in obese women with polycystic ovarian syndrome and improve sexual function. Bariatric surgery therefore should be considered for any patient with significant obesity wishing to improve their fertility who has been unsuccessful in achieving meaningful weight loss by conservative measures. Any patient wishing to conceive following bariatric surgery should be carefully monitored for nutritional deficiencies by the obstetrician, fertility specialist and dietician. Overall, bariatric surgery can significantly improve fertility, and is a safe procedure with limited effects upon mother or fetus during pregnancy.

Keywords

Bariatric surgery and fertility Fertility and bariatric surgery Obesity and fertility Fertility and obesity Weight loss and improvement in fertility 

References

  1. 1.
    Foresight. Tackling obesities: future choices- modelling future trends in obesity and their impact on health. http://www.foresight.gov.uk/ourwork/activeprojects/obesity/obesity.asp. 2009.
  2. 2.
    Robker RL. Evidence that obesity alters the quality of oocytes and embryos. Pathophysiology. 2008;15(2):115–21.CrossRefPubMedGoogle Scholar
  3. 3.
    Bellver J, Ayllón Y, Ferrando M, Melo M, Goyri E, Pellicer A, et al. Female obesity impairs in vitro fertilization outcome without affecting embryo quality. Fertil Steril. 2010;93(2):447–54.CrossRefPubMedGoogle Scholar
  4. 4.
    Penzias A. Recurrent IVF failure: other factors. Fertil Steril. 2012;97:1033–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Reis LO, Dias FG. Male fertility, obesity, and bariatric surgery. Reprod Sci. 2012;19(8):778–85.CrossRefPubMedGoogle Scholar
  6. 6.
    Magnusdottir EV, Thorsteinsson T, Thorsteinsdottir S, Heimisdottir M, Olafsdottir K. Persistent organochlorines, sedentary occupation, obesity and human male subfertility. Hum Reprod. 2005;20(1):208–15.CrossRefPubMedGoogle Scholar
  7. 7.
    Jensen TK, Andersson AM, Jørgensen N, Andersen AG, Carlsen E, Petersen JH, et al. Body mass index in relation to semen quality and reproductive hormones among 1,558 Danish men. Fertil Steril. 2004;82(4):863–70.CrossRefPubMedGoogle Scholar
  8. 8.
    Hammoud AO, Gibson M, Peterson CM, Meikle AW, Carrell DT. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril. 2008;90(4):897–904.CrossRefPubMedGoogle Scholar
  9. 9.
    Garb J, Welch G, Zagarins S, Kuhn J, Romanelli J. Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass. Obes Surg. 2009;19(10):1447–55.CrossRefPubMedGoogle Scholar
  10. 10.
    Owers C, Ackroyd R. A study examining the complications associated with gastric banding. Obes Surg. 2013;23:56–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, et al. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22(6):866–71.CrossRefPubMedGoogle Scholar
  12. 12.
    Nosso G, Angrisani L, Saldalamacchia G, Cutolo PP, Cotugno M, Lupoli R, et al. Impact of sleeve gastrectomy on weight loss, glucose homeostasis, and comorbidities in severely obese type 2 diabetic subjects. J Obes. 2011;2011:340867.CrossRefPubMedCentralPubMedGoogle Scholar
  13. 13.
    Committee (n.d.) National bariatric surgery register report. 2010.Google Scholar
  14. 14.
    Zijlstra H, Boeije HR, Larsen JK, van Ramshorst B, Geenen R. Patients’ explanations for unsuccessful weight loss after laparoscopic adjustable gastric banding (LAGB). Patient Educ Couns. 2009;75(1):108–13.CrossRefPubMedGoogle Scholar
  15. 15.
    Kaly P, Orellana S, Torrella T, Takagishi C, Saff-Koche L, Murr MM. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4(1):6–10.CrossRefPubMedGoogle Scholar
  16. 16.
    di Frega AS, Dale B, Di Matteo L, Wilding M. Secondary male factor infertility after Roux-en-Y gastric bypass for morbid obesity: case report. Hum Reprod. 2005;20(4):997–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300(19):2286–96.CrossRefPubMedGoogle Scholar
  18. 18.
    Eerdekens A, Debeer A, Van Hoey G, De Borger C, Sachar V, Guelinckx I, et al. Maternal bariatric surgery: adverse outcomes in neonates. Eur J Pediatr. 2010;169(2):191–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Huerta S, Rogers LM, Li Z, Heber D, Liu C, Livingston EH. Vitamin A deficiency in a newborn resulting from maternal hypovitaminosis A after biliopancreatic diversion for the treatment of morbid obesity. Am J Clin Nutr. 2002;76(2):426–9.PubMedGoogle Scholar
  20. 20.
    Smets KJ, Barlow T, Vanhaesebrouck P. Maternal vitamin A deficiency and neonatal microphthalmia: complications of biliopancreatic diversion? Eur J Pediatr. 2006;165(7):502–4.CrossRefPubMedGoogle Scholar
  21. 21.
    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(1):50.e1–6.CrossRefGoogle Scholar
  22. 22.
    Dao T, Kuhn J, Ehmer D, Fisher T, McCarty T. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192(6):762–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Patel JA, Patel NA, Thomas RL, Nelms JK, Colella JJ. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(1):39–45.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of Upper GI surgerySheffield Teaching HospitalsS5 7AU, SheffieldUK

Personalised recommendations