Impact of bariatric surgery on female reproduction
Received 9 November 2008; received in revised form 18 June 2009; accepted 23 June 2009. published online 10 August 2009.
Objective
To evaluate the current literature on the impact and potential mechanisms of surgical weight loss on female reproduction, with a focus on changes in reproductive hormone profile, fertility status, measures of ovarian reserve, efficacy of oral contraception, sexuality, and pregnancy.
Design
Appraisal of articles relevant to surgical weight loss and female reproduction.
Result(s)
The altered reproductive hormone profile associated with morbid obesity seems to reverse, either partially or totally, after surgical weight loss. Although bariatric surgery seems to improve fertility status and many of the complications associated with obesity in pregnancy, it may be linked to oral contraceptive failure. Although müllerian-inhibiting substance is a direct measure of ovarian reserve, its level changes with obesity and after surgical weight loss. There is a decrease or no change in the risk of miscarriage after bariatric surgery. An improvement in sexual function may follow dramatic surgical weight reduction; however, the possibility of a detrimental influence afterward can occur.
Conclusion(s)
The increasing popularity of bariatric surgery in reproductive-age women calls for greater clinician awareness of its impact on female reproduction.
Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, Albert Einstein College of Medicine, Bronx, New York; and Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York
Reprint requests: Zaher O. Merhi, M.D., Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461 (FAX: 718-430-8586).
Edward E. Wallach, M.D.
Associate Editor
Z.O.M. has nothing to disclose.
Supported by two grants (to Z.O.M.) from the Maimonides Research and Development Foundation.
ABSTRACT