The Impact of Bariatric Surgery Compared to Metformin Therapy on Pregnancy Outcomes in Patients with Polycystic Ovarian Syndrome: a Systematic Review and Meta-analysis

Chang, Catherine C.Y.; Chang, Sehoon; Poles, Jillian; Popov, Violeta

doi:10.1007/s11605-020-04900-3

Cited by 10 publications

(13 citation statements)

References 32 publications

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“…The studies were small ( n = 8–119) with a follow up of 12–46 months. The pregnancy rate was greater following surgery versus metformin 34.9% (95% CI: 0.20–0.53, I 2 = 70.2%, five studies, n = 186) versus 17.1% (95% CI: 0.12–0.23, I 2 = 0, five studies, n = 192) ( p = .026) 23 . Following BMS there was a 92% decrease in menstrual irregularity suggestive of improved ovulation 23 .…”

Section: Bariatric Metabolic Surgerymentioning

confidence: 96%

“…A recent SR of women with PCOS included 10 studies (five with metformin and five with bariatric surgery). 23 The studies were small (n = 8-119) with a follow up of 12-46 months. The pregnancy rate was greater following surgery versus metformin 34.9% (95% CI: 0.20-0.53, I 2 = 70.2%, five studies, n = 186) versus 17.1% (95% CI: 0.12-0.23, I 2 = 0, five studies, n = 192) (p = .026).…”

Section: Bariatric Metabolic Surgerymentioning

confidence: 99%

“…A recent SR of women with PCOS included 10 studies (five with metformin and five with bariatric surgery) 23 . The studies were small ( n = 8–119) with a follow up of 12–46 months.…”

Section: Bariatric Metabolic Surgerymentioning

confidence: 99%

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How to manage weight loss in women with obesity and PCOS seeking fertility?

Hazlehurst

Singh

Bhogal

et al. 2022

Clinical Endocrinology

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Obesity exacerbates the phenotype of polycystic ovarian syndrome (PCOS) including infertility as well as reducing the efficacy and access to fertility treatments. Weight management is, therefore, a key component of treatment for women with PCOS and coexistent obesity. Many women with PCOS describe significant difficulty losing weight and treatment options are limited. The first‐line treatment is lifestyle interventions though the weight loss and any impact on fertility are limited. No one dietary strategy can be preferentially recommended based on current evidence. While very low energy diets can result in significant weight loss the evidence for impact on fertility is limited. Pharmacotherapy, including a range of treatments can result in marked weight loss and there is some evidence of improved rates of conception including spontaneous and in response to assisted reproduction treatment. As with pharmacotherapy, data regarding bariatric surgery is largely from nonrandomized studies and though the significant weight loss is anticipated to improve fertility the available data prevents firm conclusions. Clinicians and patients must consider the magnitude of weight loss to be targeted as well as the anticipated fertility treatment required and the timeline of treatment when deciding upon the personalized weight loss strategy. Clinicians and patients should be confident in targeting the most appropriate treatment early in the patient's management to avoid unnecessary delays.

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Section: Bariatric Metabolic Surgerymentioning

confidence: 96%

Section: Bariatric Metabolic Surgerymentioning

confidence: 99%

See 1 more Smart Citation

How to manage weight loss in women with obesity and PCOS seeking fertility?

Hazlehurst

Singh

Bhogal

et al. 2022

Clinical Endocrinology

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show abstract

“…Irregular hormones and menstrual cycles are involved in the pathogenesis of infertility in obese women and poor sperm quality and hormonal disturbances contributes to infertility in obese men [ 3 , 4 ]. While nonsurgical weight reduction improves fertility parameters in both sexes, bariatric surgery is a more effective method in morbidly obese individuals [ 5 , 6 ]. Bariatric surgery improves fertility outcomes primarily through an improved hormonal profile [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The effects of bariatric surgery on male and female fertility: A systematic review and meta-analysis

Qurashi

Qadri

Lund

et al. 2022

Annals of Medicine &Amp; Surgery

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“…However, this may have resulted in the inclusion of some patients without those conditions but who had been prescribed the medication in question, as some of the prescribed medications can also be used in other clinical conditions, and their use is not solely limited to DM or HTN. For example, metformin may be prescribed for female patients with polycystic ovary syndrome [ 2 ], ACE inhibitors can be used in acute coronary syndrome [ 3 ], and β-blockers and CCB can also be used to treat certain cardiac arrhythmias (e.g., atrial fibrillation) [ 4 ]. Given this, some such patients may have been misidentified as diabetic or hypertensive.…”

mentioning

confidence: 99%