Posted on 07/04/2014 at 11:57 PM by Todd Eibes, MD
There is a growing number of women with concerns about pregnancy as they consider obesity weight loss surgery. Many fertility specialists and OB-GYNs will refer a patient to a bariatric specialist if they believe their weight is causing their infertility.
Obesity is one of the leading causes of infertility in the US today. 19% of women of reproductive age are obese and four times as many women have weight loss surgery than men.
There are many possible ways being overweight may cause fertility problems. The most common problem is abnormal estrogen levels which can interfere with the process of ovulation.
However, this is not the only issue. Women who are overweight have lower pregnancy rates and higher miscarriage rates even when using treatments that do not rely on ovulation such as in-vitro fertilization (IVF).
Numerous studies have shown that fertility improves with weight loss. You may become more fertile as you lose weight. But it’s important that you wait until it’s safe for you to be pregnant after your obesity weight loss surgery. You should avoid pregnancy for the first 12 months after surgery due to your rapid weight loss.
A pregnancy that occurs soon after bariatric surgery can have severe consequences for both the mother and the baby.
Your birth control pills may not work around the time of your surgery due to the medication you receive with surgery. Remember to use other methods of birth control (barrier) and talk with your family physician about this.
Once you past the one-year mark of your bariatric surgery, your risks during pregnancy are actually significantly less than when you were morbidly obese. Your risk of gestational diabetes and preeclampsia are much lower than when you were morbidly obese as well. If you require a C-section during the delivery, the surgical risk is also significantly less once you lose your excess weight.
Effective communication between your Iowa Weight Loss Specialist team and your primary care or OB-GYN physician is crucial, especially if your weight loss surgery has occurred within the previous 12 months and your weight has not stabilized. If you are pregnant or trying to become pregnant, you should be sure to mention to your prenatal team that you’ve had weight loss surgery and it is strongly recommended that you continue to communicate with your surgical team to get advice before and during your pregnancy.
You may have concerns that your post weight loss surgery diet won’t be nutritionally adequate for pregnancy. An advantage of the Sleeve Gastrectomy is that you continue to absorb nutrients normally, so your risk of vitamin deficiency is much less than with a gastric bypass.
When all factors are considered, once you have your Sleeve and you have time to get your weight under control, your fertility increases and pregnancy becomes much safer for both mother and baby.
However, please do take the following precautions:
Limit daily intake of Vitamin A to no more than 10,000 IU/day. Fetal malformations have been linked to daily exposure of 20,000 IU of Vitamin A from supplements.
Pregnancy is generally safe after obesity weight loss surgery, and complications are fewer than in women with severe and morbid obesity. Prior to becoming pregnant you should gather as much information as possible so you can make the best decisions about planning for your pregnancy after your surgery. Be sure to talk to your Iowa Weight Loss Specialist surgical team about any questions or concerns that you may have.
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