Saturday, April 13, 2024

Pregnancy After Weight Loss Surgery

Can Losing Weight Help You Get Pregnant

Amy Slaton Is Pregnant Straight After Weight-Loss Surgery! | 1000LB Sisters

The short answer is yes bariatric surgery can indeed improve fertility.

Obese women are more likely to develop complications during pregnancy, such as preeclampsia, gestational diabetes, miscarriage, and Polycystic Ovarian Syndrome .

Bariatric surgery can significantly lower your chances of encountering problems during pregnancy, decreasing the probability of a miscarriage amongst other complications.

If you are thinking about pregnancy after bariatric surgery, your body will be better prepared for fertility and carrying a baby. Excessive weight puts a great deal of strain on every aspect of your body, including your reproductive system.

Many women experience difficulties with their menstrual cycle and fertility when they are significantly overweight. After weight loss surgery, your reproductive system can finally regulate itself as your body reaps the benefits of your efforts.

Losing weight means a healthier you. And weight surgery and pregnancy go hand-in-hand as they will better equip you to handle all of the changes that will take place while you are expecting.

How To Manage A Pregnancy After Bariatric Surgery

Similar to management in preparation for and after bariatric surgery, the approach during pregnancy should continue to be multidisciplinary with an emphasis on consultations from the nutritionist and surgeon. Patient education regarding nutrition and clinical management to prevent and detect nutritional deficiencies is key.38 Furthermore, bariatric surgery is not a guarantee for weight loss, so many of these patients continue to require medical care for comorbidities.

There are several case reports of unexpected vitamin deficiencies and adverse pregnancy outcomes.3940 For these reasons, ensuring appropriate maternal nutrition before and after delivery takes precedence in prenatal care. The etiology for deficiencies vary from decreased intake of certain foods due to intolerance , decreased gastric acid secretion , and duodenal exclusion .4144 Folic acid deficiency can occur as a result of decreased gastric production of hydrochloric acid which ordinarily allows for absorption of folic acid in the upper third of the intestine.

There is no standard approach to screening and treating deficiencies during a pregnancy after bariatric surgery. As such, the approach mirrors what is recommended for the non-pregnant bariatric population. These guidelines also differ according to the type of bariatric procedure with a closer surveillance of nutrient deficiencies after malabsorptive procedures. Selective nutritional deficiencies are less common after AGB.

Your Chances Of Having A C

While women who have undergone bariatric surgery are more likely to deliver a baby via C-section, there is some debate as to why. A C-section, or a cesarean section, is a medical procedure that involves the delivery of a baby through incisions in the mothers abdomen and uterus.

In some circumstances, the C-section is scheduled in advance. In other cases, the surgery is performed due to an unforeseen issue. If you or your baby are in imminent danger, you may need to have an emergency C-section.

Although a C-section is a relatively safe procedure, it does carry more risks than a vaginal delivery. If you are concerned about your chances of having a C-section, you should consult your doctor to discuss delivery preferences.

You can also reduce your chances of having a C-section by following your doctors dietary advice, exercising during pregnancy, and taking childbirth preparation classes.

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How Does Obesity Affect Fertility

It’s not uncommon for my Ob/Gyn colleagues to refer patients whose obesity is causing infertility. In women, obesity has been shown to triple the risk of infertility.

Menstruation requires a fine hormonal balance. Many hormones are produced and stored in fatty tissue. When there is excess fatty tissue, hormones levels can become abnormal, leading to reduced fertility. Obesity also increases a womans risk of developing polycystic ovarian disease , which can cause irregular periods and infertility.

As you lose weight, these hormonal imbalances and other effects decrease. Data show that even a 5% reduction in weight when youre obese can increase your fertility. If you still need help conceiving, losing weight can increase the odds that therapies such as in vitro fertilization will be successful.

Although much of the focus on obesity and infertility is on women, it absolutely affects men as well. Obesity can lead to a drop in testosterone, which can cause infertility. Erectile dysfunction also is more common in men who are obese. In fact, obesity-related issues contribute to approximately 30% of couples’ infertility concerns.

What Are My Next Steps

Pregnancy after weight loss surgery

If you or your partner is obese and having trouble conceiving, come talk with us. We can help you determine whether lifestyle changes, fertility treatments, or bariatric surgery or a combination of approaches can help achieve your goals.

To learn more about bariatric surgery, call to set up a personal consultation. To request an Ob/Gyn virtual visit, call . Or you can request an appointment online.

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Pregnancy After Weight Loss Surgery

Many post-op patients are concerned about pregnancy afterweight loss surgery, especially the Duodenal Switch procedurewhich includes significant malabsorption. To follow is informationfrom a Duodenal Switch surgeon and testimonials from post-DSweight loss surgery moms on their experience with post-op pregnancy.Do not get pregnant until your weight has stabilized after 18to 24 months post-op and use at least TWO forms of birth controluntil cleared by your surgeon.

Vitamins A E & Selenium

Deficiencies of other nutrients such as vitamin A, vitamin E and selenium have been observed in post surgery pregnancy, however, studies have not observed any adverse outcomes as a result. Supplementation with additional nutrients is recommended on an individual basis, and should be discussed with your doctor and nutritional professional.

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How Long After Gastric Bypass Surgery Should You Wait To Get Pregnant

Although weight loss can contribute to a healthy pregnancy, you should not rush into getting pregnant after gastric bypass surgery. Your body will go through a great deal of changes from the surgery alone, and its common to be emotional and overwhelmed at times.

Bariatric surgery involves a recovery period, and you have to learn a new way of eating. Major adjustments in your lifestyle have to be made to have the best results. Getting pregnant right after gastric bypass is going to cause more upheaval in your life.

Another concern is the period when you first begin to lose weight. Your rate of weight loss can be rapid in the initial stages following bariatric surgery.

If you become pregnant too soon and experience rapid weight loss, there is the possibility that you and the baby will not receive the proper nourishment needed to thrive during this challenging time.

As a rule of thumb, give yourself at least 18 months after surgerybefore moving forward with plans to become pregnant. This will ensure you can achieve the best outcome after bariatric surgery and have a healthy pregnancy.

You May Get A Boost In Fertility

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You can get pregnant after weight-loss surgery. In fact, bariatric surgery can produce a sudden positive change in your fertility. Women with fertility problems linked to obesity who have the surgery may start ovulating regularly for the first time in years.

And if your fertility suffers because of polycystic ovarian syndrome , bariatric surgery can help. That’s because the surgery improves hormonal changes that are related to PCOS.

Weight loss of as little as 5 percent has been shown to reverse obesity-related lack of ovulation. In one study, 70 of 98 women who weren’t ovulating began normal menstrual cycles within a few months after bariatric surgery. Those who began ovulating had greater weight loss than those who didn’t.

Keep in mind that this newfound fertility can raise your chances of getting pregnant by accident if you haven’t been using birth control a problem if you’re in the initial 12-month post-surgery period . There’s some concern that oral contraceptives may not be as effective after bariatric surgery because of decreased absorption, so be sure to talk with your doctor about the best option for you. It’s a good idea to address this before your bariatric surgery to avoid an unintended pregnancy as you start to lose weight.

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What Are The Opinions About Pregnancy After Weight Loss Surgery

In most cases, pregnancy after weight loss surgery such as gastric bypass or gastric sleeve can be safe and healthy if managed well by the mother and her doctor. In addition, according to a research, undergoing weight loss surgery prior to becoming pregnant may be beneficial as it lowers the risk to obesity-related problems to the woman and their babies during pregnancy, including:

  • Developing gestational diabetes

How Might Weight Loss Surgery Affect Pregnancy And Delivery

Protein, iron, folate, calcium, and vitamins B12 and D are common nutrient deficiencies after bariatric surgery. They also are important during pregnancy.

Well check to make sure your nutrition levels are appropriate throughout your pregnancy. We also might recommend certain nutritional supplements in addition to standard prenatal vitamins.

Weight-loss surgery shouldnt affect labor and delivery and may actually decrease the risk of needing a C-section.

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Breastfeeding After Having Bariatric Surgery

Most women are concerned about whether they still can breastfeed after bariatric surgery or not. The answer is yes. Breastfeeding is recommended, however, specific attention to nutrition is still very important in this period.

If you have any type of nutrition deficiencies, this will affect your milk since it will lack the necessary supplements for your babys growth.

You can simply consult with your babys pediatrician, let them know about your bariatric surgery and your previous and current circumstances, and ask them to monitor your babys growth even more closely.

If you have not reached your ideal weight before pregnancy and youre still a bit overweight, there is a probability of after giving birth your milk comes later than usual. In this case, just talk to your doctor and ask for some advice thatll streamline the breastfeeding process.

Diet And Nutrition After Weight Loss Surgery And Pregnancy

Pregnancy After Weight Loss Surgery : Pin On Rny Information : How much ...

A weight loss surgery diet is very strict for the first months, so it requires some additional supplementation. Here, gastric sleeve seems to win over gastric bypass because it does not influence vitamins and minerals absorption . Yet, the nutritional deficiencies may pose a problem during pregnancy, especially at the beginning when women suffer from nausea and morning sickness. The best idea would be asking a dietician to compose both a weight loss surgery post-op diet and pregnancy diet then, there is the biggest chance for a woman and baby to stay nourished. The important vitamins that might need to be supplied are Folic acid, Iron, Calcium, Vitamin D and Vitamin B12. Also, any prenatal multivitamins should be taken.

The useful guidelines for women include:

  • control any vitamin deficiencies before conception and during pregnancy
  • take prenatal supplements
  • pay special attention to nutrition during the 1st trimester
  • check the level of homocysteine limit the intake of Vitamin A
  • eat 5 balanced meals a day and practise sport.

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Getting Pregnant After Weight Loss Surgery

Getting pregnant after weight loss surgery is one of the main determinants for women considering bariatric surgery. Firstly, we need to stress that getting pregnant after bariatric surgery is possible and is safe both for women and babies. A weight loss surgery in fact helps women get pregnant , lowers chances for problems during and after pregnancy, reduces weight gained during pregnancy, and facilitates weight loss after pregnancy. What may trouble women having surgery for weight loss before pregnancy is the increased chance for C-section.

There are some important aspects that pregnant women after the surgery need to pay attention to:

  • being in contact with the bariatric surgeon who performed the surgery throughout the pregnancy
  • using the help of a dietician to make sure mother and baby stay well-nourished
  • taking necessary supplements, especially calcium, folic acids, iron, Vitamin B12.

Last but not least, women should just eat balanced meals and stay active during pregnancy such a healthy lifestyle combined with a lower BMI after bariatric surgery will influence a mom and baby only in a positive way.

Contraception And Pregnancy Planning After Bariatric Surgery

Women accounted for 83% of bariatric procedures in the reproductive age group between 1998 and 2005.9 Future pregnancies were important to 30% of women planning to have bariatric surgery in one survey. 10 Infertility problems, one of the obesity related co-morbidities, commonly improve after weight loss from bariatric surgery procedures. 1114 As such, clinicians who specialize in womens health should not only be familiar with the surgery and understand the long-term goals for weight loss, but also provide appropriate counseling regarding contraception and pregnancy after bariatric surgery, regardless of whether they desire a future pregnancy. The optimal time for this counseling is prior to the bariatric surgery.

Chronic medical diseases such as obesity create barriers to contraceptive counseling. Specific to bariatric surgery, studies suggest that oral contraception may not be as effective after bariatric surgery as a result of decreased absorption.1518 Continued obesity after bariatric surgery also plays a role in planning contraception.19 Unfortunately, current practice is limited due to lacking evidence regarding the effectiveness and safety of contraception after bariatric surgery, but it is unlikely that there is a significant decrease in efficacy for oral contraceptive pills according to a recent systematic review.20

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What Bariatric Surgical Procedures Are Performed By Surgeons At Cleveland Clinic

Cleveland Clinic offers many surgical options for patients who are interested in bariatric surgery.

The most commonly performed malabsorptive procedure is called the Roux-en-Y gastric bypass. This method makes the stomach smaller and alters digestion. Less food can be eaten and fewer calories can be absorbed. The bariatric surgeon creates a small pouch by dividing the upper end of the stomach. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum , as well as the first portion of the jejunum . The procedure creates a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients.

We can also perform the sleeve gastrectomy as a laparoscopic procedure. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera and long instruments that are placed through these small incisions. During the laparoscopic sleeve gastrectomy , about 75% of the stomach is removed leaving a narrow gastric âtubeâ or âsleeveâ. No intestines are removed or bypassed during the sleeve gastrectomy. The LSG takes one to two hours to complete. We have an animated video of a sleeve gastrectomy procedure available as well.

Why Its Best To Wait Awhile

My First Trimester Recap: Weight Loss Surgery and Pregnancy

Following surgery, its best to wait at minimum one year, and better to wait 18 months to two years before becoming pregnant, says Dr. Wang. If too soon, youre at higher risk for having a small baby for the gestational age.

Because your body undergoes significant changes following surgery, its important to wait to conceive in order to be sure your fetus is not affected in any way. In the months immediately following surgery, youll follow a strict diet. Youll likely lose weight quickly, and your body wont absorb many of the vitamins and nutrients from food as effectively as it did before surgery. The most common nutritional deficiencies after weight loss surgery are calcium, protein, iron, folate, vitamin B12, and vitamin D.

If you do become pregnant shortly after having surgery, notify your health care provider and surgeon immediately. You may be advised to:

  • Avoid vomiting by
    • Gradually making the change from liquid to pureed food to solid food
    • Saving liquids for at least 30 minutes after a meal
  • Monitor nutrients in your blood level as part of prenatal care
  • See your doctor for all scheduled prenatal visits
  • Take additional vitamins

Though symptoms such as nausea and vomiting can be common during pregnancy, your surgeon will be able to determine if your symptoms are related to your pregnancy or because of the weight loss surgery.

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How Different Types Of Weight Loss Surgery Affect Pregnancy


  • There is no serious differences in terms of procedural safety or risks
  • The malabsorptive procedures like bypass and DS carry higher risk of malnutrition for mom and baby

While nutritional deficiencies may be more likely in some procedures , a study that specifically evaluated whether some surgeries are safer found that there were no serious differences between surgeries .

They evaluated laparoscopic adjustable gastric banding , vertical banded gastroplasty , and Roux-en-Y gastric bypass surgery and found that:

  • Patients following lap band surgery had significantly higher body mass index before delivery .
  • Following lap band surgery, patients had higher weight gain during pregnancy compared to the VBG and gastric bypass groups.
  • The interval between operation and pregnancy was shorter in the lap band group compared to the VBG group and was significantly higher in the gastric bypass group .
  • Birth weight was significantly higher among newborns of patients following gastric bypass surgery compared to the restrictive procedures.
  • No significant differences in low birth weight or macrosomia or perinatal mortality were noted between the groups.

A separate study of 42 pregnancies evaluated gastric bypass and lap band surgery and drew similar conclusions: no significant difference exists in the obstetric and birth outcomes between women who have undergone LRYGB and those whohave undergone LAGB .

You Still Have A Risk Of Complications

It is important to note that pregnancy after weight loss surgery can still result in potential complications. In most cases, women who have undergone bariatric surgery are still at high risk of developing complications during pregnancy.

Women who have had weight loss surgery are still at risk for gestational diabetes, but the chance is far less than before surgery. They are also more likely to develop complications such as gestational diabetes and hypertension.

Additionally, the offspring of post-bariatric patients are more likely to be born prematurely or have congenital anomalies.

To learn more about your individual risk of complications after weight loss surgery, you should consult your obstetrician or bariatric surgeon as they know your health history the best.

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