The impact of bariatric surgery on obesity-related infertility and in vitro fertilization outcomes

Orkun Tan, Bruce R. Carr

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Obesity-related infertility is one of the most common problems of reproductive-age obese women who desire childbearing. The various types of bariatric surgeries have proved effective in controlling excessive weight gain, improving fertility, and preventing certain maternal and fetal complications in these women. This article summarizes the current evidence regarding the impact of bariatric surgery on obesity-related infertility and in vitro fertilization (IVF) outcomes. We have also attempted to draw conclusions about maternal and fetal risks and the benefits of bariatric surgery. Laparoscopic adjustable gastric banding and Roux-en-Y procedures are the two most commonly performed bariatric surgeries. Bariatric surgery was believed to improve menstrual irregularity and increase ovulation rate in anovulatory obese women, which lead to increased pregnancy rates. Although there are data in the literature suggesting the improvement of both the ovulatory function and the spontaneous pregnancy rates in obese women who lost weight after bariatric surgery, most of these are case-control studies with a small number of patients. The data are insufficient to determine an ideal time interval for pregnancy after bariatric surgery; however, the general consensus is that pregnancy should be delayed 12 to 18 months after bariatric surgery to avoid nutritional deficiencies. Few data exist regarding IVF success rates in women who have undergone bariatric surgery. One pairwise study discussed five patients who underwent bariatric surgery followed by IVF that resulted in three term pregnancies in three patients after the first IVF cycle. Many studies reported reductions in obesity-related pregnancy complications such as gestational diabetes and hypertensive disorders after bariatric surgery. Although data are inconsistent, some studies reported increased rate of preterm delivery and small for gestational age infants after bariatric surgery. Pregnancies after bariatric surgery may be considered high risk due to the concerns for vitamin deficiencies and gastrointestinal symptoms related to the surgery. Therefore the follow-up of these pregnancies might require a team approach including a maternal fetal medicine specialist, bariatric surgeon, and nutritionist.

Original languageEnglish (US)
Pages (from-to)517-527
Number of pages11
JournalSeminars in Reproductive Medicine
Volume30
Issue number6
DOIs
StatePublished - 2012

Fingerprint

Bariatric Surgery
Fertilization in Vitro
Infertility
Obesity
Pregnancy
Mothers
Bariatric Medicine
Pregnancy Rate
Small for Gestational Age Infant
Birth Intervals
Avitaminosis
Gestational Diabetes
Nutritionists
Pregnancy Complications
Ovulation
Malnutrition
Weight Gain
Fertility
Case-Control Studies
Stomach

Keywords

  • bariatric surgery
  • in vitro fertilization
  • neonatal outcomes
  • obesity
  • obstetrical outcomes
  • pregnancy

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Physiology (medical)
  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

The impact of bariatric surgery on obesity-related infertility and in vitro fertilization outcomes. / Tan, Orkun; Carr, Bruce R.

In: Seminars in Reproductive Medicine, Vol. 30, No. 6, 2012, p. 517-527.

Research output: Contribution to journalArticle

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