Considering weight loss surgery is a complex decision, especially for women of childbearing age. Maybe you’re considering surgery, but you also want to have children, and you’re worried about how surgery might affect a future pregnancy. What’s the relationship between fertility and weight loss? What are the risks or benefits of having the surgery? Is it better to wait until after giving birth?
Obesity can cause hormonal imbalances that lead to fertility changes in your body. Whether you choose to pursue bariatric surgery before or after pregnancy depends on your personal health and situation.
How Obesity Impacts Fertility
Research has found that women who are obese are more likely to have irregular periods, polycystic ovary syndrome, trouble conceiving and miscarriage. But even modest weight loss improves fertility and reproductive outcomes.
Losing weight before becoming pregnant through lifestyle modifications improves your health and helps ease pregnancy and childbirth. Getting closer to a healthy weight may also move you out of a high-risk pregnancy category.
Benefits of Weight Loss Surgery
Following a healthy eating and exercise plan will greatly improve your health, but these aren’t always enough to lose weight. Some people still struggle with obesity no matter what lifestyle changes they make. Adding surgery to the equation allows you to finally get results from all the hard work you’re putting in with diet and exercise.
“With my patients, we talk about the tripod of success: surgery, permanent diet changes and permanent exercise,” said Dmitry Nepomnayshy, MD, a bariatric surgeon with Lahey Health. “If you take away any one leg, the tripod falls down.”
No matter what point in your life you decide to have weight loss surgery, the process is the same. You work with a team of psychologists, nutritionists and weight loss specialists to help you establish sustainable lifestyle habits that support a healthy weight. This isn’t a time for crash dieting or extreme exercise. You usually have six to eight visits over several months before surgery to adjust to the lifestyle changes. The goal is to ensure that you will get the most benefit from surgery.
To qualify for weight loss surgery, you must have a body mass index over 40 or over 35 with another condition, such as diabetes or sleep apnea. In general, that translates to about 100 pounds overweight for most people. People who stick with the tripod strategy usually see an average weight loss of about 60 to 65 percent of excess weight over five years, Nepomnayshy said.
Before or After Pregnancy?
Whether you choose surgery before or after a pregnancy depends on your health. Having surgery before may make it easier for you to get pregnant. It’s best to wait at least a year after surgery before trying to conceive, Dr. Nepomnayshy said. By having surgery before pregnancy, you can lower your risk of gestational diabetes and preeclampsia, a dangerous form of high blood pressure during pregnancy.
“If you lose weight in advance, you may be more likely to become pregnant and have a healthier pregnancy,” he said.
Childbirth, including vaginal delivery, after surgery is generally safe. You may need additional monitoring during pregnancy, but Dr. Nepomnayshy assures patients that even with surgery, your baby gets plenty of nutrition.
On the other hand, some women may not struggle much with weight but suddenly find it extremely difficult to lose any extra pounds after getting pregnant. Your body undergoes changes, and sometimes diet and exercise just aren’t enough.
To have surgery after pregnancy, you need to wait until your weight has stabilized and qualify for surgery. After having kids, establishing healthy habits empowers you to reach your goals. You’re also ready to set a positive example for your kids, not to mention have the energy to chase them around.
Talk to your doctor about what the best weight loss options might be for you based on your current health and your fertility plans.