Zaman Amal Yaseen
Obstetrics and Gynecology, Taibah University, College of Medicine, Department of Obstetrics and Gynecology, Al Madinah Munawara, Saudi Arabia.
Int J Surg Case Rep. 2023 May;106:108100. doi: 10.1016/j.ijscr.2023.108100. Epub 2023 Apr 7.
Morbid obesity negatively affects patients' life quality in several ways. One of the major obesity-related problems is getting pregnant, even when using assisted reproductive technology. Obesity contributes to anovulation and menstrual irregularities, with a lower conception rate, a lower response to fertility treatment, poor implantation, low-quality oocytes, and miscarriages. Managing morbid obesity and then assessing the pregnancy outcome is crucial.
We reported a case of a 42-year-old woman who had primary infertility for 26 years, polycystic ovary syndrome (PCOS), and a body mass index (BMI) of 51. She was able to get pregnant after having bariatric sleeve surgery, which brought her BMI down to 27. She had a successful pregnancy and live birth by Intrauterine insemination (IUI) from the first trial.
Patients with morbid obesity (BMI 35) and obesity-related health problems have often turned to bariatric surgery as their first line of treatment. Extremely overweight females with PCOS and infertility may benefit more from bariatric surgery.
Extremely overweight females with PCOS and infertility may benefit more from bariatric surgery, such as laparoscopic sleeve gastrectomy, than rather than only a healthier lifestyle change. Larger studies that assess the effect of bariatric surgeries in highly morbid females with PCOS are needed.
病态肥胖会在多个方面对患者的生活质量产生负面影响。肥胖相关的主要问题之一是怀孕困难，即便使用辅助生殖技术亦是如此。肥胖会导致无排卵和月经不规律，受孕率降低、对生育治疗反应不佳、着床困难、卵母细胞质量差以及流产。控制病态肥胖并随后评估妊娠结局至关重要。
我们报告了一例42岁女性，她原发性不孕26年，患有多囊卵巢综合征（PCOS），体重指数（BMI）为51。在接受袖状胃切除术使BMI降至27后，她成功怀孕。通过首次宫腔内人工授精（IUI），她成功妊娠并顺利分娩。
患有病态肥胖（BMI≥35）及肥胖相关健康问题的患者常常将减肥手术作为首选治疗方法。患有PCOS且不孕的极度超重女性可能从减肥手术中获益更多。
患有PCOS且不孕的极度超重女性可能从减肥手术（如腹腔镜袖状胃切除术）中比仅通过更健康的生活方式改变获益更多。需要开展更大规模的研究来评估减肥手术对患有严重PCOS的肥胖女性的影响。
