Infertility in Women: How Bariatric Surgery May Help

Improving Infertility in Women with PCOS: The Impact of Bariatric Surgery on Reproductive Health

The relationship between PCOS, obesity and infertility has been documented for many years. Anovulation, miscarriage, impairment in follicle formation and altered activity are the known effects of these. These women also face difficulty in managing diabetes, pre-eclampsia, growth disorders, higher rates of caesarean delivery, higher maternal mortality, and increased children’s risk for metabolic disease in the future.

A considerable weight loss can increase the chances of spontaneous ovulation, which is why the solution – bariatric surgery. This surgery is known to improve both fertility and pregnancy in women with reproductive concerns, polycystic ovarian syndrome (PCOS), along with metabolic syndrome (MS).

Bariatric Surgery’s Positive Effect on Women

Bariatric surgery in reproductive-age women has been shown to decrease menstrual irregularities. Women suffering from hormonal imbalance show considerable improvement postoperatively, and chances of conceiving increase after this surgery. Sensitivity to leptin levels increases post-surgery, reflecting improved reproductive metabolic status. Many women (about 10%-25%) with subclinical hypothyroidism, haven also shown a significant improvement following surgical weight loss.

Women already take pregnancy into consideration when electing for bariatric surgery. Nowadays women undergoing surgery are aware of their own reproductive risks and a significant number of these women are thinking ahead.

Studies on Infertility in Women and Bariatric Surgery

Bariatric surgery has attracted the interest of many scholars with more individuals showing improved fertility post-weight loss treatment. An older study implied that a BMI drop greater than 5 kg/m² was a significant predictor of fertility within 2.5 years of follow-up after surgery. There was also a trend of a reduced need for fertility treatment in women conceiving within 3 years of weight loss surgery compared to their need for fertility treatment prior to surgery. Reports also show previously anovulatory women conceiving post-operatively without ovulation induction agents.

Comparing Pregnancy Outcomes in Women Pre and Post-Bariatric Surgery

A study comparing pregnancy outcomes in women before and after weight loss surgery showed improvements in pregnancy-related hypertension and diabetes mellitus, and a significant drop in caesarean delivery rate too. Moreover, bariatric surgery did not result in increased rates of post-partum haemorrhage, infection, shoulder dystocia or foetal demise.

The benefits of bariatric surgery in women suffering from PCOS with metabolic syndrome are discussed extensively on various platforms, leading in favour of surgery in such cases. Nutritional and vitamin deficiencies in these women during that time frame of rapid weight loss can be dealt with supervised supplementation and regular follow-ups with the surgeon and obstetrician. There were no differences in maternal complications, foetal outcomes or delivery complications, making bariatric surgery a highly recommended solution and one of the best ways to lose weight in morbidly obese people.

The Gulf Obesity Crisis

Gulf Obesity Crises: The Global Health Challenge

Obesity is now the biggest healthcare challenge worldwide, approximately one in three is either obese or overweight. Gulf obesity has particularly surged, overtaking malnutrition and infectious diseases as the world’s no.1 health problem.

Obesity in the Middle East

The problem is even bigger in the Middle East. According to one study, 51 million people in the Gulf are classed as obese. An epidemic indeed. In the same study, Qatar is reported to have the highest incidence of obese men (44 percent) in the Middle East and North Africa region, followed by Kuwait (43 percent) and Bahrain (31 percent), while the prevalence of obesity among women exceeded 50 percent in three Middle Eastern countries; Kuwait (59 percent), Libya (57 percent) and Qatar (55 percent).

Economic Impact of Obesity

Not only does obesity carry serious consequences for people’s health, but it also carries a global cost of $2 trillion, consuming 2.8 percent of the global Gross Domestic Product and demanding approximately 15 percent from the healthcare budgets of developed countries, according to the authors of the McKinsey report.

Researchers have produced the startling forecast that if current obesity rates continue, almost half of the world’s adult population will be overweight or obese by 2030.

Rising Demand for Bariatric Surgery

The demand for bariatric surgery is increasing by 20 percent annually in Gulf countries, however in many cases it is out of necessity rather than choice. Bariatric surgery is proven to reduce the risk of serious health complications associated with obesity such as cardiovascular disease, sleep apnea, certain cancers, and perhaps most pressing for the region, type 2 diabetes. According to experts, we must not believe that obesity is not self-inflicted or a lifestyle choice, rather than a critical health issue.

Challenges and Criticism

It is these damaging perceptions that have led to widespread criticism of bariatric surgery, which can cost between $8,000 and $15,000, as many claim that the procedure is becoming a substitute for a lifestyle overhaul. It is from this viewpoint that a serious stigma has emerged.

Economic and Health Benefits

An increase in bariatric procedures could also realize financial savings for governments and healthcare systems alike, as patients who have undergone surgery, are more likely to avoid life-threatening and costly conditions such as heart disease and diabetes, which currently affects approximately one in ten adults in the Middle East and North Africa region.

Youth and Bariatric Surgery in the UAE

More young patients end up undergoing bariatric surgery in the UAE

Doctors advise weight-loss procedures if children have high BMI and other health issues

Obesity Statistics in the UAE

Abu Dhabi: With obesity cases rising in the UAE, more and more younger patients are being recommended for weight-loss surgeries, experts have said.

The surgeries are a last resort in the fight against obesity and its related complications. They are often a better choice than letting children’s health get progressively worse.

Global Obesity Trends

Statistics compiled by regulator Health Authority Abu Dhabi (Haad), indicate that nearly 30 percent of school-going children in Abu Dhabi are overweight or obese and the proportion rises to 40 percent among teenagers. Worldwide obesity has nearly doubled since 1980 and in 2011 more than 40 million children under the age of five were overweight (WHO).

Unless we take some drastic and wide-ranging measures, obesity will soon become the world’s biggest and most expensive health issue ever.

A food for thought, shall we say.