Weight Loss Surgery May Improve Fertility And Pregnancy

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The number of people who are overweight or obese has been growing exponentially for more than 20 years. Nearly two-thirds of Americans age 20 or older are overweight (body mass index over 25), a third are considered obese (BMI over 30), and nearly 5 percent are morbidly obese (BMI 40+).

As many as one-third of women of childbearing age in the United States are obese. But as Dr. Rachel Keilin, of Precision Surgery In Texarkana Texas, notes, “unfortunately, being overweight is associated with having fertility problems.”

Obesity causes hormonal irregularities that interfere with both natural conception and in vitro procedures. Obesity not only makes it difficult for women to become pregnant but can also lead to significant complications during pregnancy. Miscarriage rates are higher for obese women. Hypertension, gestational diabetes and pre-eclampsia are more likely, and the risk of premature and still-births is also increased.

Weight loss surgery can significantly reduce all these risks—yet few women are even aware that this option exists for them.

Bariatric Surgery Lowers Risk Of Pregnancy Complications

Recently, researchers from Ben-Gurion University of the Negev's Faculty of Health Sciences in Israel found that among obese women who had bariatric surgery before getting pregnant, the risk of gestational diabetes dropped 60 percent.* Hypertensive disorders, including severe pre-eclampsia, also declined, as did the occurrence of diabetes mellitus and anemia.

Dr. Keilin, who received her M.D. and surgical training at the Baylor College of Medicine, at the Texas Medical Center in Houston, notes that following weight-loss surgery, women who had fertility problems can be surprised to find themselves expecting unexpectedly: “It’s actually something that we warn a lot of our patients about, that the first year, when you’ve lost a lot of weight, you may think you have fertility problems – you may not six months later.”

Bariatric surgeons actually recommend that patients not get pregnant for at least 18 months following surgery, while they are still adjusting to a demanding nutritional change. However, if someone does become pregnant soon after surgery, the risks are lower with lap-band surgery. Since lap band surgery does not involve altering the intestinal tract, nutritional deficiencies for mother and child are not as big a danger as after gastric bypass surgery. And during pregnancy the lap band itself can be adjusted to allow the pregnant woman to eat more to ensure that she and her child have adequate nutrition.

Following childbirth, the flexibility of the lap band continues to provide benefits according to Dr. Keilin. While a woman is “breastfeeding, and trying to take care of young children after that, the Lap-Band is ideally suited…ou can actually adjust the Band down, so that you can eat more, so that you can get sort of bigger nutrition that you need during pregnancy, and during breastfeeding, and then adjust it back once pregnancy and breastfeeding is over.”

*”Effect of bariatric surgery on pregnancy outcome,” by Adi Y. Weintraub, Amalia Levy, Isaac Levi, Moshe Mazor, Arnon Wiznitzer and Eyal Sheiner, International Journal of Gynecology and Obstetrics, 103 (3), p.246-251, Dec 2008

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