Weight Loss Surgery for Fertility
It is difficult to get pregnant for the obese woman; particularly those with Polycystic Ovarian Syndrome who are already weight loss resistant. Some experts claim that the only reliable method for the morbidly obese to lose weight and keep it off is weight loss surgery (WLS). This article will examine why this extreme attempt at lasting weight management may be very suited to the needs of the woman hoping to increase her odds at fertility.
Roux en Y Procedure – How is it Done?
The most common type of Gastric Bypass Surgery for weight loss for the extremely obese is offered to people with a body mass index (BMI) over 40, or who are more than 100 lbs. overweight.
The surgery works in two ways: a reduced stomach size making caloric intake smaller, and by purposefully allowing malabsorption. A stomach pouch is created, bypassing the larger portion of stomach, and connected to the intestines directly. A section of intestine – a few feet - is first removed to slow the absorption process done there. The remaining (and larger) stomach portion is re-connected farther down the intestine to allow enzymes and stomach juices to combine with the contents eaten to help digestion.
Patients can expect to lose 60% of the extra weight they need to lose, thereby not being a quick fix, but taking them off the morbidly obese radar. A special diet is then required to be followed for the rest of the person’s life.
Polycystic Ovarian Syndrome – What is it?
PCOS is a hormonal condition whereby a woman produces too many male hormones (androgens) and fluctuating levels of female hormones, particularly Luteinizing
Hormone (LH), however, there are many symptoms and the condition is difficult to diagnose. It is often a question of ruling out other, more threatening conditions before coming to the conclusion of PCOS (or Stein-Leventhal syndrome as it is also known). The condition is marked by (any but not necessarily all) of the following:
- Insulin resistance/raised levels on fasting insulin
- Facial hair (hirsutism)
- Rapid onset of weight & Obesity
- Secondary amenorrhea (no periods for 3 months or longer)
- Oily skin and dandruff
- Long menstrual cycles
- Infertility
- Skin tags and discolourations
- High cholesterol
- High blood pressure
- Multiple, small cysts covering the ovaries
As this is a hormone imbalance, depression, moodiness, and aches and pains are common complaints. There is no cure and little is known about the disease. It is estimated that between 5 – 10% of the population are stricken with PCOS, making it the number one cause of infertility today. Medical professionals are in agreement that the best method of treatment is weight loss. Since this is highly difficult in a person who suffers from Polycystic Ovarian Disease, it becomes a vicious cycle.
Return of Periods
Nearly immediately, even in cases where women have never had regular (or experience entirely absent) periods, their menstruation vastly improves much of the time. It is not entirely understood, but it does seem to have something to do with the gastrointestinal hormone production that takes place in the stomach and intestinal areas, as well as the added benefit of weight loss in general. Interestingly, serotonin (a major player in mood disorders) is secreted in the intestinal cell walls as well as the brain. This can possibly help to explain why many patients after having WLS describe feeling satiated and more content, often times no longer requiring antidepressant medications (something only a doctor can decide).
After surgery, doctors advise against pregnancy strongly for a minimum of 1 ½ to 2 years time, since rapid weight loss is not conducive to a healthy pregnancy. This can be frustrating since many PCOS women opt for WLS for the very purpose of having a baby, but it is important to follow your doctors’ advice. During this wait time, two methods of contraception are advised, namely barrier methods (condoms), along with hormonal contraception (the pill) because little is known about the effective absorption of medications after the surgery.
Heather Allan - Freelance writer, Lover of Pets and Children, Diplomas in both Software Engineering and Writing for Publication.
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