Reproductive Outcomes Differ Following Roux-en-Y Gastric Bypass and Adjustable Gastric Band Compared with Those of an Obese Non-Surgical Group

Abstract

Background: Little is known about how bariatric surgery type may impact reproductive health outcomes. Our objective was to determine differences in infertility and birth outcomes among women who underwent Roux-en-Y gastric bypass (RYGB), adjustable gastric band (AGB), and an obese non-surgical group.

Methods: Women aged 18-45 who were evaluated for bariatric surgery were invited to complete a survey. Pre- and post-surgery outcomes were compared among women who underwent RYGB vs. AGB and to those of obese women who decided against surgery. Outcomes included infertility, time to conception from first attempt, use of infertility services, pregnancy, live birth, and birth weights. Logistic and linear regression, controlling for age, BMI, weight, and pregnancy history, were used to calculate odds ratios (ORs) and beta-coefficients with 95 % confidence intervals (CIs).

Results: Two-hundred nineteen surveys were completed. RYGB resulted in a reduction in menstrual cycle irregularity after surgery compared to before (OR = 0.21, CI = 0.07-0.61). For first-pregnancy outcomes, there were lower odds of term birth after RYGB than before (OR = 0.21, CI = 0.05-0.90) and increased odds of miscarriage after RYGB compared to the no-surgery group (OR = 9.81, CI = 1.12-85.71). We found lower odds of live birth after AGB than before (OR = 0.19, CI = 0.05-0.73). Birth weight was significantly lower after RYGB but not AGB (p < 0.01).

Conclusions: This small study suggests that the impact of bariatric surgery may vary by procedure type and impact menstrual regularity, live birth, and offspring birth weight. These results should be considered pilot data and support performance of a prospective study to fully investigate these preliminary findings.

Keywords: Bariatric surgery; Infertility; Obesity; Pregnancy; Time to conception.