How Bariatric Surgery Improves Fertility and Pregnancy Outcomes

Did you know that a woman’s weight, and her partner’s, can affect their fertility and pregnancy outcomes? Bariatric surgery may increase the odds of becoming pregnant and produce better pregnancy outcomes for the mom and baby.

Why Weight Affects Fertility

“Weight is very intertwined with hormones. The health of one affects the other,” shares Sarah Pratt, MD, a bariatric surgeon with ProMedica Weight Loss Surgery. Hormone imbalances have the potential to wreak havoc on your fertility and pregnancy outcomes.

Dr. Pratt shares that for women, bariatric surgery essentially hits the reset button on their hormones. It helps women get back to normal menstrual cycles with regular ovulation. For women with polycystic ovary syndrome (PCOS), it can also decrease other symptoms.

For men, bariatric surgery can help increase testosterone levels and sperm counts. Testosterone is broken down into estrogen by fat cells. When weight loss occurs, there’s less fat in the body to break it down, resulting in a boost in testosterone levels.

How Weight Affects Pregnancy Outcomes

By improving moms’ health pre-pregnancy, we can improve the baby’s health. 

“Patients who have an increased weight have higher insulin resistance and higher blood sugar, which puts them at a higher risk of fetal abnormalities,” shares Shannon Connole, DO, an OB-GYN with ProMedica Physicians Obstetrics | Gynecology – Maumee. “Decreasing weight will increase the chances of a healthier pregnancy.”

Pregnant women with a healthy body mass index (BMI) have a lower risk of miscarriage, stillbirth, and having babies with chromosomal or heart abnormalities.

Risks of other pregnancy complications for moms, such as gestational diabetes, preeclampsia and emergency cesarean sections (C-sections), also go down.

How Maternal Obesity Impacts Baby Long Term

A mother’s pre-pregnancy weight and weight during the pregnancy also can impact the baby when they are out of the womb.

“Mothers who have a higher BMI are at a greater risk of having larger babies or babies that need to be admitted to the NICU,” Dr. Connole shares. “As these children grow up, they are at an increased risk of developing Type 2 diabetes and having neurodevelopmental disorders such as ADHD.”

Who is a good candidate for bariatric surgery?

Patients who are overweight or obese, having a BMI over 40, or a BMI over 35 with another existing comorbidity, qualify for bariatric surgery.

Before surgery, you will meet a team of dietitians, physical therapists and behavioral health specialists to create a diet and exercise plan and ensure you are mentally prepared for the procedure.

Setting realistic weight loss goals that still allow you to achieve your pregnancy goals is important. “Oftentimes, losing just 5-10% of your body weight is enough for a healthy pregnancy to occur,” Dr. Connole shares.

How soon can you get pregnant after surgery?

Women should wait 12-18 months after bariatric surgery before becoming pregnant. “This gives your body time to lose the weight and recover, and allows us to check your vitamin levels to make sure that your body can support a healthy pregnancy before becoming pregnant,” Dr. Pratt shares.

Using proper contraceptive methods after bariatric surgery is important for recovery and to make sure that post-surgery protocol can be completed before becoming pregnant. 

Dr. Connole shares that there is a significant change in a woman’s ability to become pregnant after bariatric surgery. “I have many patients who accidentally get pregnant because they weren’t expecting their fertility to improve so drastically and so quickly.”

Sarah Pratt, MD
Dr. Pratt is a bariatric surgeon with ProMedica Weight Loss Surgery. View her profile. 

Shannon Connole, DO
Dr. Connole is an OB-GYN with ProMedica Physicians Obstetrics and Gynecology. View her profile.