How does bariatric surgery affect fertility and pregnancy?

People who are considering bariatric surgery and wish to have a baby may wonder how the procedure affects their ability to get pregnant. Commonly known as weight-loss surgery, bariatric surgery is a procedure involving the stomach or intestines to treat obesity, defined as having a body mass index (BMI) between 30 and 30.9, while severe obesity is a BMI over 40.

Excess body fat can pose health risks, such as high cholesterol, joint pain and sleep apnea. When traditional methods, such as dieting, exercising regularly and taking medication have not worked, bariatric surgery can offer help for weight loss as well as improvement in these conditions as well as Type 2 diabetes and hypertension.

“Bariatric surgery isn’t meant to be a quick fix but rather serve as an effective tool to treat obesity,” says Dr. George Mueller, a Sharp Community Medical Group surgeon and the medical director of Bariatric Surgery at Sharp Memorial Hospital. “It’s important to eat nutritious food and exercise regularly after bariatric surgery to help maintain a healthy weight.”

Bariatric surgery before pregnancy

Women considering bariatric surgery should know that it can increase the chances of getting pregnant. Pregnancy can occur spontaneously within a year after surgery, as hormone levels related to fertility increase.

Additionally, studies show that menstrual cycles become regular in women who have had bariatric surgery, boosting the chances of getting pregnant. However, depending on the bariatric surgery type and a woman’s health, experts recommend waiting one to two years after the procedure before becoming pregnant.

“Bariatric surgery patients can lose up to 50% or more of excess body weight,” says Dr. Michael Morell, a bariatric surgeon affiliated with Sharp Coronado Hospital. “Waiting to conceive after surgery helps stabilize a woman’s hormones, nutrient levels and weight to promote a safe pregnancy.”

Bariatric surgery’s effect on pregnancy

A recent study found that women who had bariatric surgery gained less weight during pregnancy than those who did not have a bariatric procedure. Maintaining a healthy weight during pregnancy is important, as women with a high BMI are at risk for developing gestational diabetes.

Gestational diabetes occurs when the body can’t produce or use enough insulin during pregnancy, increasing the risk of pre-term delivery and health issues for the baby, such as breathing problems or hypoglycemia (low blood sugar), at birth. Gestational diabetes can also cause preeclampsia, marked by persistent high blood pressure during pregnancy. And preeclampsia can lead to heart disease or organ damage in the mother.

Research indicates that women who had bariatric surgery are less likely to develop gestational diabetes and preeclampsia than women who have not had the procedure. However, as with every pregnancy, women who have had bariatric surgery should work closely with their OBGYN to monitor their nutrient levels during their pregnancy.

“Our team, consisting of nurses and dietitians, offers post-surgery services, such as support groups to assist patients in maintaining a healthy weight and achieving their goals,” says Dr. Mueller. “This can include getting pregnant.”

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