How are Fertility and Bariatric Surgery Connected?

Nearly half of U.S. women of childbearing age are either overweight or struggling with obesity, which can potentially cause issues during pregnancy. These issues include things like high blood pressure, gestational diabetes, premature birth, and a greater chance of needing a C-section. For some women carrying excess weight, simply attempting to get pregnant can be a struggle.

As you gain weight, the ovaries release more estrogen. If they produce too much estrogen, the body could think you're already pregnant or taking a hormonal birth control pill, which means you may not ovulate or get a period. Obesity also increases the risk of developing polycystic ovary syndrome (PCOS), which can cause irregular periods and infertility. Obesity can also make in vitro fertilization (IVF) treatments less successful.

In some cases, lifestyle changes like diet, exercise, or using weight loss medications can help you get to a healthier weight. For those who have been unsuccessful at losing weight through diet and exercise alone, weight loss surgery can be an effective tool that can help lead them to a healthy weight and possibly a pregnancy.

As with any surgery, many factors need to be considered before you decide to proceed. With weight loss surgery specifically, even more questions may come to mind about how a pregnancy could play out down the line. If you're planning to become pregnant, a vertical sleeve gastrectomy is generally recommended. Also known as the “gastric sleeve” or "VSG", this procedure is the most common weight loss surgery performed in the U.S. and abroad. The sleeve results in patients losing an average of 50% to 70% of their excess body weight and keeping most of it off long-term. With this procedure, vitamin and other nutrient deficiencies are less of a concern during a potential pregnancy when compared to other operations. Keep in mind that every woman's body is different, so all patients should have a conversation with their doctors to determine which procedure is the best choice for them in the long term.

Timing wise, it’s best to wait 12-18 months after weight loss surgery before attempting to become pregnant to ensure that the body is ready for all the changes to come. You must be at a stable weight (no longer actively losing) with your nutrition as optimized as possible to be able to support both you and your baby. As you’re fully recovering from surgery, you may not have regular periods, but that doesn’t mean you can’t get pregnant! Birth control during this waiting period is important. An IUD is generally recommended, as oral contraceptives may not work as well after weight loss surgery because of the changes in the stomach's absorption of medications. It’s best to wait at least two weeks after surgery to resume sexual activity, but for some people it can be weeks or months until they feel fully healed or comfortable.

If you are struggling with fertility and looking for weight loss options, contact Louisiana Center for Bariatrics for a consultation. Your OB/GYN or primary care provider can also connect you with other resources. You can even check out an upcoming weight loss surgery seminar.

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Lyndsey Bruno, MD
Louisiana Center for Bariatrics 
(225) 763-4903