Department of Bariatric and Metabolic Surgery, GEM Hospital & Research Center, Coimbatore, Tamil Nadu, 641045, India.
Obes Surg. 2020 Feb;30(2):383-390. doi: 10.1007/s11695-019-04245-0.
Obesity has a derogatory effect on female reproductive health. Obesity contributes to difficulty in natural conception, increased risk of pregnancy-associated complications, miscarriages, congenital anomalies, and also the long-term negative impact on both mother and the child.
Our study aimed to analyze and assess the reproductive health-associated outcomes of females who underwent bariatric surgery.
We performed a retrospective analysis from a prospectively collected database from June 2013 to June2016. Out of 71 females studied, 45 patients (63.5%) had completed 3 years of follow-up. The data were collected from inpatient and outpatient records. Patients were studied under three groups (A, patients with polycystic ovarian disease (PCOD) symptoms; B, patients with primary infertility; and C, patients who conceived after bariatric surgery that were included in groups A and B).
Out of 45 patients studied, 40 patients underwent laparoscopic sleeve gastrectomy (LSG), four patients underwent laparoscopic Roux-en-Y gastric bypass (RYGB), and one patient underwent laparoscopic adjustable gastric banding (LAGB). The mean BMI of the patients was 43.64 ± 6.8 kg/m. PCOD symptoms improved symptomatically (p = 0.001) after surgery in the group. Seven (43.75%) primary infertility patients conceived after surgery. Three (42.9%) patients conceived naturally while 4 (57.1%) conceived with ART in group B. Out of total population of 45 in group C, percentages of patients who delivered baby with short gestational age (SGA), low birth weight (LBW), normal vaginal deliveries (NVD), and maternal anemia were 63.15%,47.3%,73.4%, and26.3%, respectively.
Obesity is closely associated with primary infertility and PCOD. Menstrual abnormalities associated with PCOD significantly improve after bariatric surgery with significant improvement in fertility along with maternal outcomes.
肥胖对女性生殖健康有不良影响。肥胖会导致自然受孕困难、妊娠相关并发症风险增加、流产、先天畸形，并且还会对母亲和孩子产生长期的负面影响。
我们的研究旨在分析和评估接受减肥手术的女性的生殖健康相关结果。
我们对 2013 年 6 月至 2016 年 6 月期间从一个前瞻性收集的数据库中进行了回顾性分析。在 71 名女性中，有 45 名患者（63.5%）完成了 3 年的随访。数据来自住院和门诊记录。患者分为三组（A 组，多囊卵巢病（PCOD）症状患者；B 组，原发性不孕患者；C 组，减肥手术后怀孕的患者，包括 A 组和 B 组）。
在 45 名研究患者中，40 名患者接受了腹腔镜袖状胃切除术（LSG），4 名患者接受了腹腔镜 Roux-en-Y 胃旁路术（RYGB），1 名患者接受了腹腔镜可调节胃束带术（LAGB）。患者的平均 BMI 为 43.64 ± 6.8 kg/m²。A 组患者手术后 PCOD 症状得到了明显改善（p = 0.001）。7 名（43.75%）原发性不孕患者在手术后怀孕。B 组中有 3 名（42.9%）患者自然受孕，4 名（57.1%）患者通过辅助生殖技术（ART）受孕。在 C 组的 45 名总人群中，有早产（SGA）、低出生体重（LBW）、自然分娩（NVD）和母亲贫血的婴儿的百分比分别为 63.15%、47.3%、73.4%和 26.3%。
肥胖与原发性不孕和 PCOD 密切相关。减肥手术后，与 PCOD 相关的月经异常明显改善，同时生育能力和母婴结局也显著改善。
