How Bariatric Surgery Can Help Some Women Improve Fertility
Having children is oftentimes one of the great joys in people’s lives. But there can be many obstacles to getting pregnant—one of them being obesity. Six percent of obese women who have never been pregnant struggle with fertility. Thankfully, there’s a solution: bariatric surgery.
To learn more about how bariatric surgery can help women who are obese and want to have children, we spoke with Kristin Noonan, MD, bariatric surgeon and director of surgical quality and safety at Jefferson Health – Abington’s Institute for Metabolic & Bariatric Surgery.
Obesity’s Link with Fertility
There are many reasons why obese women may have trouble getting pregnant. One of those reasons is an imbalance in hormone levels. “An excess in adipose tissue—also called body fat— leads to elevated levels of estrogen, making it difficult for the ovaries to function properly,” says Dr. Noonan. High levels of estrogen have also been linked to polycystic ovary syndrome (PCOS), a common cause of infertility in women.
Obesity can cause physical and psychosocial issues as well. Obese women may be more self-conscious about their bodies and abnormal hormone levels may lead to a lower sex drive, making women less willing to participate in intercourse, thereby limiting opportunities to get pregnant. In addition, anatomic limitations may make it difficult for sperm to be deposited appropriately.
How Bariatric Surgery Can Help
For obese women trying to get pregnant who haven’t been able to lose weight through other strategies, bariatric surgery is an excellent option. Not only will you be more likely to get pregnant, but your body will also be in a healthier state to carry a baby.
“The healthier you are going into pregnancy, the healthier your pregnancy will be, and the healthier your baby will be,” says Dr. Noonan. “Getting pregnant after bariatric surgery, when your body has reached its steady-state weight, will lower your risk of complications like miscarriage, hypertension, preeclampsia, gestational diabetes and C-section.”
“Bariatric surgery has become an increasingly effective approach for achieving sustainable weight loss, as well as reducing the morbidities associated with severe obesity,” said Joel I. Sorosky, MD, Chair, Department of Obstetrics-Gynecology, Jefferson Health – Abington. “Nearly half of bariatric surgeries are performed in reproductive aged women. Our bariatric program has helped to improve the lives of hundreds of women who have gone on to have successful pregnancies.”
Timeline is Important
For those who struggle with obesity and wish to have children, Dr. Noonan says not to wait. “Some women will wait to consider bariatric surgery until they’re toward the end of their childbearing years or have developed medical problems. Obesity combined with advanced maternal age can compound the risks of infertility, miscarriage and pregnancy complications. This isn’t a surgery to hold off on if you are obese and you want to have kids.”
To be eligible for bariatric surgery, you should have a BMI of 40 or higher or 35 or higher with obesity-related medical problems, and have been unsuccessful losing weight on your own. After bariatric surgery, you’ll need to wait until you’re at your steady-state weight and nutritionally sound to try to get pregnant. This usually takes about 12 to 18 months but, of course, it will depend on the individual.
Before Your Pregnancy
If you’ve had bariatric surgery and are planning for pregnancy, you should discuss it with your bariatric team and your OB/GYN. They both should have details on your surgery so they can help guide you along in your pregnancy in a safe and healthy way. Your doctors will also help make sure you’re nutritionally sound and have the right levels of vitamins, as well as recommend a prenatal vitamin.
Your bariatric care team is there to help you through any of life’s challenges, both before and after surgery, so it’s important to keep them informed of your plans. “We love hearing stories of our bariatric patients who struggled with infertility who are now able to have children after surgery. We even keep a collection of photos of our ‘bariatric babies’ in the office,” says Dr. Noonan.