The Effect of Bariatric Surgery on Ovarian Reserve in Obese Patients with Primary Infertility
https://doi.org/10.31550/1727-2378-2024-23-4-73-78
Abstract
Aim. To describe two clinical cases of obese female patients with primary infertility who underwent sleeve gastrectomy.
Key points. The presented clinical cases demonstrate the multidirectional impact of bariatric surgery on ovarian reserve indicators in two patients of reproductive age with primary infertility, comparable in degree of obesity and concomitant diseases. In both patients, 12 months after surgery, body weight was successfully reduced and carbohydrate metabolism levels were normalized. However, in the first patient, the level of anti-Mullerian hormone (AMH) increased slightly, and pregnancy occurred, while in the second patient, on the contrary, the level of AMH decreased compared to the preoperative level, and the desired pregnancy did not occur at the time of writing.
Conclusion. Literary data on the impact of bariatric surgery on women's reproductive function are scarce and contradictory. Determining the contribution of metabolic surgical interventions to restoring ovarian reserve, normalizing AMH levels and overcoming infertility will allow individualizing treatment tactics in obese patients.
About the Authors
S. V. Dora
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Dora, S.V.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
Z. V. Shvets
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Shvets, Z.V.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
G. V. Semikova
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Semikova, G.V.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
K. V. Azizova
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Azizova, K.V.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
A. R. Volkova
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Volkova, А.R.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
Yu. Sh. Khalimov
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Khalimov, Yu.Sh.
6-8 Lev Tolstoy Str., Saint Petersburg, 197022
References
1. Gorbatenko N.V., Bezhenar V.F., Fishman M.B. Obesity and reproductive health of women. Obesity and Metabolism. 2017;14(1):3–8. (in Russian). DOI: 10.14341/OMET201713-8
2. Raykova A.A. Obesity as a risk factor of menstrual disorders in women of childbearing potential. V.F. Snegirev Archives of Obstetrics and Gynecology. 2016;3(4):213–14. (in Russian). DOI: 10.18821/2313-8726-2016-3-4-204-224
3. Gesink Law D.C., Maclehose R.F., Longnecker M.P. Obesity and time to pregnancy. Hum. Reprod. 2007;22(2):414–20. DOI: 10.1093/humrep/del400
4. Kesharwani D.K., Mohammad S., Acharya N., Joshi K.S. Fertility with early reduction of ovarian reserve. Cureus. 2022;14(10):e30326. DOI: 10.7759/cureus.30326
5. Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil. Steril. 2020;114(6):1151–7. DOI: 10.1016/j.fertnstert.2020.09.134
6. Moslehi N., Shab-Bidar S., Ramezani Tehrani F., Mirmiran P. et al. Is ovarian reserve associated with body mass index and obesity in reproductive aged women? A meta-analysis. Menopause. 2018;25(9):1046–55. DOI: 10.1097/GME.0000000000001116
7. Kataoka J., Larsson I., Björkman S., Eliasson B. et al. Prevalence of polycystic ovary syndrome in women with severe obesity — effects of a structured weight loss programme. Clin. Endocrinol. (Oxf). 2019;91(6):750–8. DOI: 10.1111/cen.14098
8. Delamuta L.C., Fassolas G., Dias J.A., Henrique L.F.O. et al. Antimüllerian hormone levels and IVF outcomes in polycystic ovary syndrome women: a scoping review. JBRA Assist. Reprod. 2024;28(2):299–305. DOI: 10.5935/1518-0557.20230059
9. Artemenko Yu.S., Khamoshina M.B., Ryabova V.A., Zyukina Z.V. Obesity in women: current aspects of reproductive health disorders. Medical Council. 2022; 5:32–9. (in Russian). DOI: 10.21518/2079-701X-2022-16-5-32-39
10. Andreeva E.N., Sheremetyeva E.V.,Fursenko V.A. Obesity — threat to the reproductive potential of Russia. Obesity and Metabolism. 2019;16(3):20–8. (in Russian). DOI: https://doi.org/10.14341/omet10340
11. Seryogina D.S., Nikolayenkov I.P., Kuzminykh T.U. Obesity represents a strong pathogenetic link with the pathology of pregnancy and childbirth. Journal of Obstetrics and Women’s Diseases. 2020;69(2):73–82. (in Russian). DOI: 10.17816/JOWD69273-82
12. Milone M., De Placido G., Musella M., Sosa Fernandez L.M. et al. Incidence of successful pregnancy after weight loss interventions in infertile women: a systematic review and meta-analysis of the literature. Obes. Surg. 2016;26(2):443–51. DOI: 10.1007/s11695-015-1998-7
13. English W.J., Williams D.B. Metabolic and bariatric surgery: an effective treatment option for obesity and cardiovascular disease. Prog. Cardiovasc. Dis. 2018;61(2):253–69. DOI: 10.1016/j.pcad.2018.06.003
14. Merhi Z.O., Minkoff H., Feldman J., Macura J. et al. Relationship of bariatric surgery to Müllerian-inhibiting substance levels. Fertil. Steril. 2008;90(1):221–4. DOI: 10.1016/j.fertnstert.2007.05
15. Vincentelli C., Maraninchi M., Valéro R., Béliard S. et al. One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women. J. Assist. Reprod. Genet. 2018;35(7):1317– 24. DOI: 10.1007/s10815-018-1196-3
16. Lv B., Xing C., He B. Effects of bariatric surgery on the menstruationand reproductive-related hormones of women with obesity without polycystic ovary syndrome: a systematic review and meta-analysis. Surg. Obes. Relat. Dis. 2022;18(1):148–60. DOI: 10.1016/j.soard.2021.09.008
17. Pilone V., Tramontano S., Renzulli M., Monda A. et al. Evaluation of anti-Müller hormone AMH levels in obese women after sleeve gastrectomy. Gynecol. Endocrinol. 2019;35(6):548–51. DOI: 10.1080/09513590.2018.1559285
18. Kloos J., Coyne K., Weinerman R. The relationship between antiMüllerian hormone, body mass index and weight loss: a review of the literature. Clin. Obes. 2022;12(6):e12559. DOI: 10.1111/cob.12559
19. Consalvo V., Canero A., Salsano V. Bariatric surgery and infertility: a prospective study. Surg. Technol. Int. 2017;31:327–30.
20. Bezhenar V.F., Fishman M.B., Gorbatenko N.V. The place of bariatric surgery in restoring the reproductive health of obese women. V.F. Snegirev Archives of Obstetrics and Gynecology. 2016;3(2):106–7. (in Russian). DOI 10.18821/2313-8726-2016-3-2-104-107
21. Buyukkaba M., Turgut S., Ilhan M.M., Ekinci I. et al. Anti-Mullerian hormone levels increase after bariatric surgery in obese female patients with and without polycystic ovary syndrome. Horm. Metab. Res. 2022;54(3):194–8. DOI: 10.1055/a-1756-4798
22. Nilsson-Condori E., Hedenbro J.L., Thurin-Kjellberg A., Giwercman A. et al. Impact of diet and bariatric surgery on anti-Müllerian hormone levels. Hum. Reprod. 2018;33(4):690–3. DOI: 10.1093/humrep/dey032
Review
For citations:
Dora S.V., Shvets Z.V., Semikova G.V., Azizova K.V., Volkova A.R., Khalimov Yu.Sh. The Effect of Bariatric Surgery on Ovarian Reserve in Obese Patients with Primary Infertility. Title. 2024;23(4):73-78. (In Russ.) https://doi.org/10.31550/1727-2378-2024-23-4-73-78
Views:
43
Email this article 