Improvement in Fertility After Bariatric Surgery in Obese Females with Polycystic Ovarian Syndrome: Based on Four Years of Experience in Two Centers in Sulaimani Governorate, Kurdistan Region/Iraq

摘要

Background: Obesity affects every aspect of life in obese patients and, in particular, it affects their quality of life. Increased body weight beyond normal is linked to many diseases such as infertility. Polycystic disease of the ovaries is common in childbearing females, with incidence of 7% in the population and 2/5 to 4/5 of this group are either overweight or obese. Changes in all aspects of quality of life after bariatric surgeries were studied widely. One aspect that needs more elaboration is the improvement of fertility in obese patients with polycystic ovarian syndrome (PCOS) postbariatric surgery. Setting: All operations and follow-ups were carried out at the Hatwan Private Hospital for Laparoscopic and Bariatric Surgery and the Obesity Unit at the Sulaimani Teaching Hospital (Sulaimani Governorate, Kurdistan Region/Iraq). Methodology: The prospective observational study was from a total 167 patients who underwent sleeve gastrectomy for a period of 4 years (from July 4, 2012, to July 5, 2016). Of all the patients, 123 were female with a male to female ratio of 4.3 to 1.23. Forty-two of the female patients had primary goal of improvement in their fertility. Of these 42 obese patients, 8 had PCOS, they were evaluated, and included in this study. These patients were compared in the conception of case matching to eight other patients who were obese and infertile, but otherwise healthy. All study participants were interviewed by the same team, and a questionnaire was administered relating to information on the patient's gynecological and obstetric aspects of life, before and after operation. Results: Of the 123 female patients who underwent bariatric surgery, 8 of them were obese and married with PCOS, with a body mass index of 40-60 kg/m(2), and a primary aim of becoming fertile. Patients with primary and secondary infertility were included. Conclusion: Significant changes in fertility were recorded in obese females with PCOS postbariatric surgery as early as 3 months after the operation. This was particularly true in patients with a shorter duration and onset of obesity after the age of 18 years.