Bariatric surgery and fertility.
OBJECTIVE
Bariatric surgery is the most reliable way to sustain weight loss in the morbidly obese. Reproductive age women comprise the majority of bariatric patients, and many may be interested in conceiving after surgery. The purpose of this review is to synthesize the recent literature on bariatric surgery and fertility to assist providers in patient counseling.


RESULTS
Obesity adversely impacts fecundability and IVF outcomes through a variety of mechanisms. The body of literature on reproductive outcome after bariatric surgery is sparse and of mixed quality. Bariatric surgery has been shown to improve menstrual cyclicity in anovulatory women, but little is published on the impact of surgical weight loss on spontaneous or IVF-treatment-related pregnancy rates. The increased risk of miscarriage in obese women may decline after bariatric surgery. There are currently insufficient data to support recommendations regarding the ideal timing for pregnancy after bariatric surgery.


CONCLUSIONS
Obesity has been shown to adversely impact fertility, and weight loss is associated with significant improvement in many parameters of reproductive function. Further research is required as to the specific impact of surgical weight loss on pregnancy and miscarriage rates, as well as the optimal timing of pregnancy after bariatric surgery.
Shah
Divya K
DK
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, USA.
Ginsburg
Elizabeth S
ES
D000022:Abortion, Spontaneous; D050110:Bariatric Surgery; D005260:Female; D005298:Fertility; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D007248:Infertility, Male; D008297:Male; D009765:Obesity / Q000150:complications / Q000601:surgery; D011247:Pregnancy; D018873:Pregnancy Rate; D013997:Time Factors