More and more we learn about our neighbors and friends having difficulty conceiving. In fact, about 14% of couples in industrialized countries report infertility problems. There is a growing body of evidence that indicates lifestyle choices such as diet and body negatively impact female fertility. Obesity has a strong association with infertility and menstrual irregularities. While some of the ovulation problems and menstrual changes are explainable by women with Polycystic Ovarian Syndrome (PCOS) who are also obese, women who do not have PCOS but are overweight also have the same problems. Weight loss has been shown to restore ovulation. It is thought that the improvement in insulin resistance has more to do with restoring ovulation than the actual amount of weight or weight loss itself. Recent studies indicate that previously infertile women who undergo gastric bypass surgery and lose massive weight are then able to conceive and deliver healthy babies. Opponents of gastric bypass weight loss surgery say the restrictive and malabsorptive nature of the gastric bypass prohibits a woman from having a healthy pregnancy and delivering a healthy baby. But the actual numbers indicate a greater risk to women and their unborn child if they are morbidly obese. The United States Surgeon General lists several reproductive complications associated with pregnancy in women who are obese. Complications include an increased risk of death in both the baby and the mother and increases the risk of maternal high blood pressure by 10 times. In addition to many other complications, women who are obese during pregnancy are more likely to have gestational diabetes and problems with labor and delivery. The Surgeon General concludes that Infants born to women who are obese during pregnancy are more likely to be high birth weight and, therefore, may face a higher rate of Cesarean section delivery and low blood sugar (which can be associated with brain damage and seizures). Obesity during pregnancy is associated with an increased risk of birth defects, particularly neural tube defects, such as spina bifida. In a study by Dr. Alan C. Wittgrove, past president of the American Society of Bariatric Surgery and pioneer of the laparoscopic technique, post-gastric bypass pregnancy indicates fewer risks than commonly reported by women who are obese during pregnancy. His study was conducted with nurse-practitioner Leslie Jester who had a low-risk pregnancy and delivered a healthy baby after gastric bypass surgery. The study found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesity. There were no patients with clinically significant anemia. Dr. Wittgrove concluded, Since the patients had an operation that restricts their food intake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies. The post-surgical group had fewer pregnancy-related complications than did an internally controlled group that were morbidly obese during their previous pregnancies. |
