Does sleeve gastrectomy or gastric bypass affect pregnancy?

Question

Hello doctor,

I am 36 years old and desperately need help with my weight and health problems. I currently weigh 348 pounds, 5 feet 7 inches with a basal metabolic index (BMI) over 54. I was diagnosed with polycystic ovarian syndrome (PCOS) at 19 and developed type 2 diabetes four years ago, with a current A1c of 8.7 despite taking Metformin 1000 mg(milligrams) twice daily and Glipizide. My blood pressure stays around 158/94 mm Hg even while taking Lisinopril and Hydrochlorothiazide. I was recently diagnosed with moderate sleep apnea with an apnea-hypopnea Index (AHI) of 28, and I use a continuous positive airway pressure (CPAP) machine but still wake up exhausted. My cholesterol is poor, with triglycerides at 378, low-density lipoprotein (LDL) at 192, and high-density lipoprotein (HDL) at only 29, despite taking Rosuvastatin. The joint pain in my knees and back is so severe that I struggle to go up the stairs in my own house. I have tried every diet, even losing 70 pounds on the ketogenic diet two years ago, but I gained it all back, plus more. My fertility doctor says I likely will not be able to conceive at my current weight, and my husband and I desperately want children. I recently tried Semaglutide for three months but developed severe pancreatitis with a lipase level over 1200 and had to stop. I am considering metabolic surgery but am terrified of complications and worried that my PCOS will not improve after surgery. Would gastric bypass or the gastric sleeve be a better option for someone with my condition? How would either affect my chances of pregnancy in the future? What kind of success rates for diabetes remission should someone like me expect? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Given your complex medical history and current health challenges, it is understandable to feel overwhelmed. Both gastric bypass and sleeve gastrectomy are effective metabolic surgeries, but they have different implications for your conditions.

Gastric bypass:

Often recommended for patients with severe obesity and type 2 diabetes.
Can lead to significant weight loss and improvement in diabetes control.
May improve PCOS (polycystic ovarian syndrome) symptoms and fertility.
Has a higher risk of nutritional deficiencies, requiring lifelong supplementation.

Sleeve gastrectomy:

Also effective for weight loss and diabetes management.
May have a lower risk of nutritional deficiencies compared to gastric bypass.
Can improve PCOS symptoms and fertility, but the impact might be less pronounced than with gastric bypass.

Both surgeries can improve your chances of pregnancy by reducing weight and improving metabolic health. However, it is crucial to work closely with your healthcare team to monitor your progress and manage any complications. In terms of diabetes remission, many patients experience significant improvements, with some achieving remission. The success rate varies, but studies show that a substantial number of patients see marked improvements in their diabetes control after surgery.

Please book a consultation with me if you would like more detailed information on any of these points, or if you have other questions.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.