Pregnancy and bariatric surgery

Many women who opt for a surgical weight-loss procedure, do so because they would like to start a family. Chronic weight problems can have a detrimental effect on fertility, whilst bariatric surgery is known to dramatically increase the chances of conceiving. Not only that; surgery reduced the risks of pregnancy-associated complications for both mother and child and improves long-term health prospects for both

Most experts agree that pregnancy is better delayed until after weight-loss has stabilised following surgery. A recent large study from the Netherlands, in which scientists analysed the results from 51 studies across the world, has shed more light on this. The main findings are:

• Overall, bariatric surgery has a positive impact on fertility; following surgery obese women had a much higher chance of becoming pregnant.
• Most women who could not conceive spontaneously prior to surgery, did so afterwards.
• There was no association between surgery and miscarriage or risk of congenital malformations.

However, the researchers advise women to delay pregnancy until after their weight-loss has stabilised following surgery. This is because adequate nutrition is critical in the early months of pregnancy and all bariatric surgical procedures – especially gastric bypass – have the potential to create deficiencies of both fat- and water-soluble vitamins and minerals.

Appropriate dietary supplementation and measurement of key nutrients to ensure that blood levels are stable, is essential prior to discontinuing post-operative contraception.

Dr David Ashton MD PhD