The worldwide upward trend in obesity has been dramatic, now affecting more than 20% of women of their reproductive age. Women with Polycystic ovarian syndrome (PCOS) who are also obese demonstrate a more severe metabolic and reproductive phenotype. PCOS is depicted by hyperandrogenism, polycystic ovaries, and anovulation. It increases the risk of insulin resistance (IR), type 2 diabetes, obesity, and cardiovascular disease. PCOS is the cause of up to 30% of infertility in couples seeking treatment. Currently, there is no cure for PCOS.
Symptoms of PCOS are delayed menses and pigmentation in private parts and facial hair. Infertility and hypothyroidism also increase Obesity as these diseases will never allow young women to lose weight even after long tiring exercises & diet modifications.
Many patients would have tried all sort of non-surgical methods to lose weight like exercises, Keto diets & Medications. Initially they might lose few kgs but in long term they gain back the lost extra kilos because of water weight comes back quickly.
Infertility cases are increasing nowadays, because along with polycystic ovarian disease, sedentary and faulty food eating habits also will worsen the condition. These patients would have tried many cycles of IVF to conceive but they would have failed, the reason being morbid obesity. The solution for these young women’s weighing 20 to 30 kgs more than ideal weight and metabolic syndrome or with BMI 30+ qualify for Bariatric Surgery. Those patients ideally better to undergo bariatric/metabolic surgery which allows them to shed those extra kgs and reverse the PCOS which enable them to conceive them in natural methods.
Bariatric surgery is the most durable and effective treatment for morbid obesity and results in the improvement of the metabolic syndrome. With the safety of the laparoscopic approach and improved understanding of the metabolic changes occurring in bariatric patients postoperatively, morbidly obese women with infertility secondary to PCOS have responded to bariatric surgery. Historically, epidemiological studies have suggested that the rapid weight loss in the first year or two after bariatric surgery may increase women’s chance of conception. While the incidence of PCOS decreases significantly after surgery, there are studies assessing fertility before and after bariatric operations.
Relevant changes in the hormone profile and significant alterations in the gonadotropic and insulin patterns were seen after Bariatric Surgery. In addition to satisfactory weight loss, the observed endocrine alterations revealed an internal environment that was more homeostatic and conducive to reproduction, indicating that Bariatric Surgery was able to produce attractive physiological outcomes for women with PCOS .
Considering bariatric and metabolic surgery as one of the options for obese young females to lose weight and conceive naturally. For public with Health Insurance, now Insurance companies to approve Bariatric/Metabolic surgery as per the guidelines of Insurance Regulatory Development Authority of India (IRDAI).
I am Anam and I was 136 Kgs with severe PCOS. I was gaining weight day by day, and not menstruated for 2 Years and tried all ways of losing weight management. After marriage I was suffering from Infertility too and my family was concerned about my health & Infertility issues. I approached the Bariatric Surgeon and recommended me for Metabolic Surgery. Post-surgery, I am happy to share that I am not only reduced my weight to 80 Kgs now but also blessed with a bundle of joy in my family.
For any queries of the article contact the author, Dr. G Moinoddin, Bariatric and Advanced Laparoscopic Surgeon, Dr. Moin Minimally Invasive Surgery, Manipal Hospitals,Millers Road, Bangalore. Mobile: 99206 62598. Email: karnal.moin@gmail.com
