Can Bariatric Surgery Improve Fertility?
Learn the reproductive benefits of weight-loss surgery
Learn the reproductive benefits of weight-loss surgery
Bariatric surgery, commonly called weight-loss surgery, has helped millions of very overweight people lose excess weight — but the benefits can include more than just a lower number on the scale. It can also reduce the risk of chronic diseases, such as diabetes and heart disease and improve sleep quality. In addition, bariatric surgery can provide a lesser-known benefit: improved reproductive health.
“Being significantly overweight may affect fertility in both women and men. Women may have a more difficult time becoming pregnant, and men may have sperm counts that are lower than they should be,” says Lian Lim, MD, a bariatric surgeon at Scripps Clinic Hillcrest. “Achieving a healthier weight can often improve these issues.”
Bariatric surgery is designed for people who have severe obesity and have not been able to lose weight through diet and exercise. Patients typically qualify for bariatric surgery if they have a BMI of 40 or higher or have a BMI of 35-39 with other health issues such as diabetes, high blood pressure, cardiac disease or sleep apnea.
Weight-loss surgeries, such as the gastric bypass or gastric sleeve, reduce the stomach size limiting how much someone can eat. The gastric bypass in addition decreases the calories absorbed by the body. These surgeries have helped many people successfully lose considerable amounts of weight, improve health problems, as well as resolve associated fertility problems.
How can bariatric surgery improve fertility and pregnancy?
When a woman is overweight, the excess weight may cause hormone imbalances. This, in turn, may affect her ovulation cycles and ability to become pregnant. Women who are overweight also have a higher risk of polycystic ovary syndrome (PCOS), a condition that causes the body to produce abnormal levels of androgens (male hormones). This results in fluid-filled cysts forming on the ovaries, which can interfere with ovulation and fertility.
“After bariatric surgery, women can see a large improvement in hormonal balance, allowing their reproductive hormones to function better and many will resume having menstrual cycles,” says Dr. Lim. “In men, sperm count increases.”
Moreover, women who have a healthy weight during pregnancy and delivery have a lower risk of complications, such as gestational diabetes and premature birth.
How soon should a woman try to conceive after bariatric surgery?
While reproductive hormones respond quickly to bariatric surgery, the general recommendation is to wait at least 18 months after surgery before trying to get pregnant.
Following the procedure, patients need time to complete their weight loss before they conceive, as losing weight while pregnant is never recommended. In addition, the body’s vitamin levels need to be stable enough to support a growing baby and prevent complications such as fetal malnutrition and low birth weight.
Pregnancy following bariatric surgery is considered a high-risk pregnancy and requires a multidisciplinary team of experts. Along with your bariatric surgeon and obstetrician, your care team may include a maternal and fetal medicine specialist who specializes in high-risk pregnancies and a dietitian to help ensure you and your baby receive adequate nutrition. In most cases, you will be closely monitored throughout your pregnancy and may have more frequent ultrasound exams and screenings to help reduce the risk of complications.
“Bariatric surgery can be a promising option for helping people with obesity have a baby, but it is a major surgery with many considerations and requires long-term lifestyle changes,” says Dr. Lim. “It should be considered after patients have tried to lose weight through other methods and have met with both a fertility specialist and a bariatric surgeon.”