Deciding if you should pursue weight loss surgery is no easy decision. This is especially the case for women who are looking to get pregnant. The common fear is that weight loss surgery may affect a woman’s ability to bear children in the future.
While there will always be risks associated with surgery of any type, the most recent reports make it clear that pregnancy is very much safe after weight loss surgery.
In fact, it’s safer to be pregnant after weight loss surgery than it is to be pregnant while obese.
What Impact Does Obesity Have on Fertility?
Obesity has been identified as a significant contributor to female infertility. Obesity can lead to a range of issues, such as Polycystic Ovarian Syndrome (PCOS). This disorder leads to irregular menstrual periods and contributes to difficulties getting pregnant. Further complications can include gestational diabetes, miscarriage, and preeclampsia.
Losing even a modest amount of weight, however, can lessen your chances of developing such disorders and improve fertility. While losing weight through a combination of lifestyle changes and surgery can be a tall order, the rewards of improving your chances at a successful pregnancy is well worth the commitment.
What About IVF?
In Vitro Fertilization (IVF) is a process that involves manually extracting eggs and fertilizing them with sperm in a laboratory dish. Once fertilization has taken place, the embryo is transferred to the uterus.
IVF is often used to treat infertility in the following cases:
- Women with uterine fibroids or ovulation disorders
- Cases of male factor infertility
- Blocked, damaged or removed fallopian tubes
While IVF may seem like a viable option for obese women, they are often not qualified candidates for it. A 2012 systematic review revealed that those who deal with excessive levels of body fat are 10% less likely to give birth to a live infant after IVF.
Furthermore, obese women still run the risk of developing complications such as gestational diabetes and preeclampsia. Risks aside, IVF can be expensive and draining, and the chances of success are not very high for obese women.
Is It Really Safe to Have Children After Bariatric Surgery?
Bariatric surgery is becoming more common, and an increasing number of women are opting for surgery to shed unhealthy levels of body fat.
While it’s generally safe for a woman to have children after bariatric surgery, it’s recommended they wait at least 18 months after surgery before attempting to get pregnant.
Not only will the patient be recovering during this time, but the body may also have nutritional deficiencies that must be corrected with proper supplementation.
It’s important to note that women who undergo lap-band surgery will experience weight loss at a slower pace and will generally not experience any issues regarding nutrition deficiencies.
As such, women who get banded should wait at least six months before attempting pregnancy to ensure they’re at a healthy weight level to avoid possible complications.
Your bariatric surgeon will likely advise you to use contraceptives as you wait for your body to recover. As long as you follow the instructions of your surgeon, you will eventually begin to lose weight, which will greatly increase your chances of having a healthy pregnancy.
Watching Your Nutrition Levels
Because weight loss surgery involves significant measures to induce weight loss, your nutrition levels may be affected adversely.
Take biliopancreatic diversion, for example, a surgery that involves removing a portion of the stomach which can cause nutritional deficiencies and malabsorption. As a result, around 20% of women who undergo this surgery may have to feed intravenously during pregnancy to ensure their bodies have sufficient nutrition levels.
On the other hand, women who undergo gastric bypass surgery or gastric banding will experience little to no risk to their nutritional levels as long as the patient listens to their doctor’s advice following surgery.
It’s vitally important that your obstetrician be aware of the specific type of bariatric surgery you underwent as this will help them to better advise you. It’s equally important to stay in contact with your bariatric surgeon throughout your pregnancy to ensure you’re receiving proper nutrition supplements.
There are no general recommendations regarding the specific quantity of nutrients a pregnant woman should take post-surgery. Each case is unique. Thus, your bariatric surgeon should advise you on the types of nutrients you should be taking daily as well as the quantity you should be taking.
Be mindful that women who have undergone malabsorptive weight loss surgery (such as biliopancreatic diversion or gastric bypass surgery) may require blood tests regularly to check for nutrient deficiencies while pregnant.
All women who become pregnant post-surgery should ensure they’re intaking sufficient levels of the following nutrients:
- Calcium
- Folate
- Vitamin D
- Iron
- Vitamin B12
Most prenatal vitamins should contain all of the essential nutrients you need to have a successful pregnancy. It’s generally suggested that women incorporate prenatal vitamins into their diet before becoming pregnant. Speak with your bariatric surgeon to ensure you’re taking the right nutrients.
Avoiding Excessive Weight Gain While Pregnant
It’s important to note that bariatric surgery does not “cure” obesity. Depending on lifestyle choices, such as diet and exercise, it’s possible to regain weight.
Pregnant women should be especially mindful of this fact. Putting on too much weight during pregnancy can put the fetus at risk.
The best way to maintain healthy weight levels during pregnancy is to adopt a healthy diet. Speak with your dietician to receive advice on the type of foods you should be eating while pregnant.
While this is sound advice, it’s certainly easier said than done. Pregnancy can have abnormal effects on hormonal levels, which may cause a pregnant mother to experience a range of side effects, such as sudden urges to eat, nausea, and even food aversions. All of these factors can make sticking to a healthy diet a challenging endeavor.
However, your dietician should help keep you on track during this challenging time. If it’s safe, you can also work to keep your weight in check by exercising daily.
It’s common for women to gain weight during pregnancy, whether they’ve had bariatric surgery or not. If you pick up weight post-pregnancy, don’t panic. Speak with your dietician to develop a diet and exercise routine to help you shed the pounds and continue forward with your weight loss journey.
Losing the weight won’t happen overnight, so you’ll need to be patient to regain the figure you had before pregnancy, and don’t forget to take your vitamins daily!
Is It Safe to Breastfeed After Bariatric Surgery?
Due to possible nutritional deficiencies, post-surgery breastfeeding is a common concern for women who become pregnant after undergoing bariatric surgery.
Thankfully, most women should be able to breastfeed with no problems post-surgery as long as they take nutritional supplements daily and monitor their nutrition levels.
Speak with your doctor to ensure you’re getting the nutrition you need to breastfeed safely.
Specific Issues Regarding Pregnancy After Gastric Banding
Gastric banding can be seen as one of the most convenient forms of bariatric surgery because the band can be adjusted or even deflated during pregnancy. Symptoms, such as vomiting and nausea, may require some women have their bands completely deflated.
Don’t be afraid to tell your bariatric surgeon if you’re feeling unwell during your pregnancy. If, for instance, you’re experiencing severe morning sickness, you can request to have your band deflated to help ease your symptoms.
Your band can also be loosened to allow you to eat more, though this may come with risk if you’re prone to overeating. Generally speaking, the vast majority of women who have undergone gastric banding can generally cope with the side effects of pregnancy without having to adjust their bands.
Gastric banding patients may also experience trouble swallowing sizeable prenatal vitamin pills. They run the risk of the vitamin remaining in their esophagus which may cause ulcers to form. They also run the risk of heartburn.
Speak with your obstetrician regarding this issue. In most cases, they will prescribe liquid or chewable prenatal vitamins as an alternative.
Improving Fertility Through Weight Loss Surgery
Pregnancy after weight loss surgery is a very real possibility for most patients. If diet, exercise, and medication aren’t working for you, then it may be time that you considered weight loss surgery.
The prospect of going under the knife may be terrifying to future mothers to be, but bariatric surgery makes it possible for women to have the families they’ve always dreamed about without running the risk of encountering the complications associated with obesity.
Reducing weight is also key to lowering risks of developing high blood pressure, diabetes and cancer. If you’ve reached your last straw reach out to a bariatric surgeon to inquire about surgery.
References:
https://americanpregnancy.org/infertility/in-vitro-fertilization/
https://www.ncbi.nlm.nih.gov/pubmed/22144420
https://www.livescience.com/14584-overweight-pregnant-women-limit-weight-gain.html
https://www.healthline.com/health-news/how-unhealthy-is-it-for-overweight-women-to-go-through-ivf#Excess-weight-affects-fertility
