Effectiveness of Bariatric Surgery-Induced Weight Loss on Infertility Among PCOS and Non-PCOS Women: Experience of a Maternity Hospital and In Vitro Fertilization (IVF) Center in India

Obesity, mostly the abdominal deposition of fat, is prevalent with polycystic ovarian syndrome (PCOS) influencing fertility. Evidence suggests a significant surge in the number of women who became pregnant after bariatric surgery (BS). The objective of this study is to evaluate the role of bariatric surgery-induced weight loss prior to pregnancy on various parameters, with special focus on infertility among women with and without PCOS. A single-center retrospective cohort study, comprising 28 women {PCOS (n = 17) and without PCOS (n = 11)} with a history of infertility, who underwent bariatric surgery for morbid obesity. Retrospective analysis was performed for pregnancy rate, weight loss (in terms of body mass index), anti-mullerian hormone (AMH) levels, oral glucose tolerance test (OGTT) value, and serum insulin levels. The mean of total pregnancy rate was 64.28%. At 1-year follow-up, the mean BMI among all the study participants decreased from 49.11 pre-surgery to 29.33 post-surgery. Similarly, the prevalence of impaired OGTT reduced from 42.85 to 3.57% among the study groups. The AMH levels were within the normal range for both the groups after surgery, but were not statistically significant. The study showed the positive role of bariatric surgery on overall health in both groups. Also, bariatric surgery was favorable on the reproductive health of women as well as in managing other metabolic co-morbidities like impaired OGTT and serum insulin levels in PCOS as well as non-PCOS women.