Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
Curr Opin Obstet Gynecol. 2010 Jun;22(3):248-54. doi: 10.1097/GCO.0b013e3283373be9.
Bariatric surgery is the most reliable way to sustain weight loss in the morbidly obese. Reproductive age women comprise the majority of bariatric patients, and many may be interested in conceiving after surgery. The purpose of this review is to synthesize the recent literature on bariatric surgery and fertility to assist providers in patient counseling.
Obesity adversely impacts fecundability and IVF outcomes through a variety of mechanisms. The body of literature on reproductive outcome after bariatric surgery is sparse and of mixed quality. Bariatric surgery has been shown to improve menstrual cyclicity in anovulatory women, but little is published on the impact of surgical weight loss on spontaneous or IVF-treatment-related pregnancy rates. The increased risk of miscarriage in obese women may decline after bariatric surgery. There are currently insufficient data to support recommendations regarding the ideal timing for pregnancy after bariatric surgery.
Obesity has been shown to adversely impact fertility, and weight loss is associated with significant improvement in many parameters of reproductive function. Further research is required as to the specific impact of surgical weight loss on pregnancy and miscarriage rates, as well as the optimal timing of pregnancy after bariatric surgery.
减重手术是治疗病态肥胖症患者维持体重减轻的最可靠方法。育龄妇女是减重手术的主要人群，许多人可能对手术后怀孕感兴趣。本综述的目的是综合最近关于减重手术和生育力的文献，以帮助提供者为患者提供咨询。
肥胖通过多种机制对生育能力和 IVF 结果产生不利影响。关于减重手术后生殖结果的文献很少，且质量参差不齐。减重手术已被证明可改善无排卵妇女的月经周期，但关于手术减肥对自然或 IVF 治疗相关妊娠率的影响的研究较少。肥胖女性流产的风险增加可能在减重手术后下降。目前还没有足够的数据支持关于减重手术后妊娠的理想时机的建议。
肥胖已被证明对生育能力有不利影响，而体重减轻与生殖功能的许多参数显著改善相关。还需要进一步研究手术减肥对妊娠和流产率的具体影响，以及减重手术后妊娠的最佳时机。
