Successful pregnancy in morbidly obese lady with polycystic ovary syndrome after bariatric surgery: A case report

Abstract

Introduction Obesity has been proven to have adverse effects on fertility and is one of the predisposing factors for delay in pregnancy even with the use of assisted reproductive technique. There are many pathways in which obesity can affect fertility such as anovulation, poor implantation and low-quality oocyte. Case presentation We report a case of a 40-year-old lady with primary infertility for six years with underlying polycystic ovary syndrome (PCOS) and BMI 45.7 whom was successfully conceived twice following bariatric surgery procedure in which reduction of 70% of her BMI prior to bariatric surgery lead to her spontaneous conception without fertility intervention and successful live birth. Clinical discussion Obese PCOS needs multidisciplinary approaches which include weight loss program such as dietary advice, exercise intervention as part of preliminary treatment prior to ovulation induction and counselling. Conclusion Bariatric surgery has been a mainstay treatment in patients with morbid obesity and those with BMI more than 35 associated with obesity related problems such as joint pain, hypertension or diabetes mellitus. Bariatric surgery such as laparoscopic sleeve gastrectomy should be considered more often in contrast to lifestyle modification for morbidly obese lady with PCOS and infertility prior to the use of standard ovulation induction regime for treating infertility.

Successful pregnancy following gastric sleeve surgery for long-duration primary infertility: A case report

“…The World Health Organization (WHO) reports that 39 % of the global population has a BMI of 25 or higher, and 13 % has a BMI of 30 or higher [1] . Numerous comorbidities, such as elevated blood pressure, arthritis, cancer, and type 2 diabetes, have long been associated with obesity [1] , [2] , [3] , [4] , [5] . Overweight or obese pregnant women have higher chances of developing gestational diabetes, preeclampsia [6] , [7] , [8] spontaneous miscarriage [9] , large for gestational-age children, and fetal abnormalities [10] .…”

“…Obesity promotes PCOS and substantially affects the efficacy of treating all components of the condition, including infertility. The chance of miscarriage, congenital abnormalities, and other pregnancy-related issues is increased, and it affects the likelihood of conceiving and responding to fertility treatment [2] . Most people who struggle with obesity have a predisposition due to genetics, a poor diet, and a lack of physical activity, which in turn exacerbates metabolic disturbances.…”