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Wednesday, December 05, 2012 - Weight-loss Surgery Can Help Boost Fertility for Obese Women and Men

Weight-loss surgery can help boost fertility for obese women and men

By Lisa Dobruskin, M.D., F.A.C.S.

Obesity-related infertility is one of the most common problems of overweight reproductive-age women trying to become pregnant. Scientists and medical professionals say the rise in obesity could be partly to blame for the rise in infertility. But new findings are proving what we bariatric surgeons have long known ─ the three safest and most common surgical weight-loss procedures ─ gastric bypass, sleeve gastrectomy and gastric banding ─ have helped many couples in their quest to become pregnant. As an added benefit, significant weight-loss in obese women prior to pregnancy also helped prevent serious maternal and fetal complications during pregnancy including gestational diabetes and hypertensive disorders, such as pre-eclampsia.

Obesity and Fertility in Women

The excess number of fat cells interferes with hormone production and excess weight puts added strain on the body’s ability to function optimally, both key components to conception. The considerable weight-loss achieved by women who undergo bariatric surgery, often as much as 100 pounds or more, reduces stress on all the body’s organs. Significant weight loss can also improve menstrual irregularity and increase ovulation rate in anovulatory (non-ovulating) obese women, leading to increased pregnancy rates. Polycystic ovary syndrome, another common cause of infertility in overweight women, improves as well.

Obesity and Fertility in Men

Forty percent of men who have fertility problems are overweight and a third are obese. Additionally, obese men are three times more likely to have a low sperm count. The sperm they do retain have motility problems or are misshapen, inhibiting the sperm’s ability to enter the egg. One of the main causes of infertility in obese men is the same as in obese females. Men with excess fat cells create too much estrogen-mimicking estrone, which lowers testosterone levels and actually increases the female hormone, estrogen. Higher estrogen levels can also cause men to develop breasts and reduce sperm production. Obese men and women are also often dealing with physiological and psychological issues which can lead to lower libido and impotence in men.

Special Considerations for Post-Bariatric Women

Right now, there is no long-term data to ascertain an ideal time interval for pregnancy after bariatric surgery. However, I recommend patients wait 12 to 18 months after the operation due to possible nutritional deficiencies as a result of a reduction in food intake. During pregnancy, a woman who has undergone weight-loss surgery should be under the care of a maternal fetal medicine specialist, OB/GYN, bariatric surgeon, and dietitian in order to maintain the health of both mother and baby.

The Bariatric Weight-loss Program at CentraState Medical Center offers a personalized, multi-step treatment plan to help seriously overweight people get back on the road to health. The American Society for Metabolic and Bariatric Surgery (ASMBS) has designated CentraState as a Bariatric Surgery Center of Excellence for demonstrating a commitment to quality and safety, and a track record of favorable outcomes. New patient information seminars are offered monthly to provide more detailed information about surgical weight-loss solutions. For more information or to register for a bariatric seminar, visit centrastate.com/healthprograms. To learn more about The Bariatric Weight-loss Program at CentraState, call 866-CENTRA7 or visit centrastate.com/weightloss.

Dr. Lisa Dobruskin is a board-certified general surgeon specializing in bariatric and minimally invasive surgery. She is on staff at CentraState Medical Center in Freehold and may be reached by calling Jersey Bariatrics at (732) 446-2300, email at drd@jerseybariatrics.com or on the Internet at jerseybariatrics.com.