Weight loss to improve fertillity outcomes: how far should we go?

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Traditionally, women have been advised to delay conception for a year following bariatric surgery because of concerns over the effect dramatic weight loss may have on a developing pregnancy, however recent data from our group and others suggests that conception prior to one year following surgery may be safe, which may be preferential for those who have previously struggled to conceive or are undergoing assisted conception. Of course, bariatric surgery itself may negate the need for assisted conception, allowing patients to achieve their goal of conception and resulting potentially in short and long term cost savings for the health service in terms of provision of fertility services and provision of long term medical care for these patients.

Of course, weight loss surgery is not without its potential risks and complications and should only be considered once conservative lifestyle measures have failed. But it would seem, for those in whom lifestyle measures fail, weight loss surgery may be a credible treatment option for those with obesity-associated subfertility. This will require a shift in thinking and an open mind from patients and clinicians alike.

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