A Review of the Impact of Bariatric Surgery in Women With Polycystic Ovary Syndrome

Lee, Robert; Mathew, Christopher Joy; Jose, Merin; Elshaikh, Abeer O; Shah, Lisa; Cancarevic, Ivan

doi:10.7759/cureus.10811

Cited by 18 publications

(14 citation statements)

References 33 publications

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“…However, these improvements were associated with post-operative complications such as anastomotic ulcer, malnutrition, and gastrointestinal bleeding. Parallel to our findings, Lee et al (2020) reported a significant weight loss, improvement of hyper-insulinemia and hyperandrogenism, ovulatory function and menstrual regularity one year after bariatric surgeries.…”

Section: Discussionsupporting

confidence: 89%

The Impact of Large Volume Liposuctiom With Adrenaline Only on the Pregnancy and Aesthetic Outcomes of Infertile Obese Women

Awadeen

Maged

2021

Al-Azhar Medical Journal

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Background: Obesity dysregulates the hypothalamic-pituitary-ovarian axis resulting in ovulatory dysfunction and subsequent infertility. Tumescent liposuction comprised injection of a large volume of lactated Ringer's solution or normal saline, containing super-diluted epinephrine and lignocaine, in the subcutaneous fat. Even though this procedure accomplished accepted results as a body contouring surgery, the association between large-volume liposuction and infertility outcomes was not examined yet.Objectives: To reveal the aesthetic and reproductive outcomes of obese infertile female patients with established underlying hormonal irregularities and submitted to large-volume tumescent liposuction with the use of adrenaline only. Patients and Methods:The present prospective cohort study was conducted at Al-Azhar University Hospitals throughout September 2015 and August 2020. Obese or overweight infertile women within the reproductive age with menstrual irregularities, for at least one year were eligible for inclusion in the present study. These abnormalities were confirmed based on laboratory, and radiological evaluation. The procedure was done under general anesthesia and sterilization with betadine with small stabs in targeted areas. Postoperative pain was assessed using Visual analogue scale (VAS).Results: A total of 18 female patients with established infertility of more than one-year duration were included in this study. Patients were furtherly assorted based on fulfilling Rotterdam criteria into two groups: Group (A) including 10 patients with polycystic ovarian syndrome (PCOS), and group (B) encompassing eight patients without. Clinically, three cases of secondary infertility get pregnant after the procedure, one case get pregnant after eight months and two of them after one year. Furthermore, two cases of primary infertility with PCOS get pregnant after six months and the other after one year. Seven cases of secondary infertility developed dramatic improvement in hormonal profile preparing them for conception without pregnancy. Patients experienced a statistically significant decline in the body mass index (P<0.001, t=61.3). As for patients' satisfaction, 15 (83.33%) gave a 4 or 5 score to their general appearance. This was reflected in the quality of life in which 13 (72.22%) patients were highly satisfied. No patient complained of uncomfortable postoperative pain. Conclusion:Large-volume tumescent liposuction with use of adrenaline only was a safe, effective, and promising procedure in amending the negative reproductive and aesthetic repercussions of obesity among infertile obese women. These findings were associated with satisfactory pregnancy and cosmetic outcomes, which reflected on patients' satisfaction. No patient in our cohort experienced discomfort pain despite xylocaine non-use.

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Section: Discussionsupporting

confidence: 89%

The Impact of Large Volume Liposuctiom With Adrenaline Only on the Pregnancy and Aesthetic Outcomes of Infertile Obese Women

Awadeen

Maged

2021

Al-Azhar Medical Journal

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“…Thus, neuroregulation of the hypothalamic-pituitary-ovarian axis is severely disturbed, and these factors affect the occurrence and progression of PCOS at multiple levels ( 52 , 53 ). Although PCOS is known to improve with weight loss and that weight loss is effective in restoring IR, hyperandrogenism, and the hypothalamic-pituitary-ovarian axis ( 54 – 56 ), there is a possible weight-loss-independent mechanism for PCOS improvement after metabolic surgery. Eid et al.…”

Section: Discussionmentioning

confidence: 99%

“…There has been existing reviews and meta-analyses with the same topic ( 15 , 35 , 56 ). However, it did not impair the innovation or value of the present study.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Surgery on Patients With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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Polycystic ovary syndrome (PCOS) is a complicated reproductive endocrine disease that is closely related to obesity. Metabolic surgery ameliorates a series of clinical manifestations and related comorbidities of PCOS. However, the overall efficacy of metabolic surgery on PCOS remains uncertain. This systematic review and meta-analysis aimed to evaluate the therapeutic effects of metabolic surgery on obese patients with PCOS. A systematic literature search for relevant studies was conducted on PubMed, Embase, Web of Science, and the Cochrane Library from inception to June 2021. Data extraction and quality evaluation were performed by three researchers, and RevMan 5.4 software was used to conduct the meta-analysis. A total of 14 studies involving 501 obese patients with PCOS were included. Incidence of PCOS in obese women ranged from 5.5% to 63.5% among the included studies. The results showed the incidence of abnormal menstruation decreased from 81% to 15% (OR=0.03, 95% confidence interval (CI): 0.01–0.08), while the incidence of hirsutism dropped from 71% to 38% (OR=0.21, 95% CI: 0.06–0.74). Serum total testosterone and free testosterone levels decreased by 25.92 ng/dL (MD = -25.92, 95% CI: -28.90– -22.93) and 2.28 ng/dL (SMD = -2.28, 95% CI: -3.67– -0.89), respectively. Sex hormone-binding globulin (SHBG) levels increased by 26.46 nmol/L (MD = 26.46, 95% CI: 12.97–39.95). Serum anti-Mullerian hormone (AMH) levels decreased by 1.29 ng/mL (MD = -1.29, 95% CI: -1.92– -0.66). Small sample size studies revealed that pregnancy rates ranged from 95.2% to 100% postoperatively. Metabolic surgery contributed to marked improvement of abnormal menstruation, hirsutism, and levels of free testosterone, total testosterone, SHBG, and AMH in patients with PCOS. Our findings indicate that patients with PCOS are expected to benefit from metabolic surgery, and could help potentially improve their reproductive outcomes. Metabolic surgery could thus be a new viable option for the clinical treatment of PCOS.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021251524.

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“…Reports suggest that bariatric surgery in some PCOS women effectively improves ovulation, insulin resistance, hyperandrogenism, and hirsutism. In several obese PCOS patients, a regular menstrual cycle is restored after bariatric surgery [23]. Undoubtedly, bariatric surgery leads to weight loss and therefore results in resumed ovulation and pregnancy.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Recent Approaches in the Treatment of Polycystic Ovary Syndrome: An Update

2022

ARCH Women Health Care

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the male hormone androgen in females. It is one of the main reasons for PCOS's clinical complications, including anovulation, abnormal menstrual cycle, and infertility. Furthermore, hyperandrogenism can initiate hirsutism, acne, androgenic alopecia, and metabolic abnormalities such as obesity, insulin resistance, hyperinsulinemia, and dyslipidemia. In many PCOS women, lipid abnormalities, exceptionally high triglyceride, low high-density lipoprotein cholesterol levels, and impaired fibrinolysis have been observed.PCOS and associated complications physically affect the female body, and the complicated connection between genetics, environment, and hormones instigates mental health problems [4]. Reports suggest

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A Review of the Impact of Bariatric Surgery in Women With Polycystic Ovary Syndrome

Cited by 18 publications

References 33 publications

The Impact of Large Volume Liposuctiom With Adrenaline Only on the Pregnancy and Aesthetic Outcomes of Infertile Obese Women

The Impact of Large Volume Liposuctiom With Adrenaline Only on the Pregnancy and Aesthetic Outcomes of Infertile Obese Women

Metabolic Surgery on Patients With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Recent Approaches in the Treatment of Polycystic Ovary Syndrome: An Update

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