Bariatric Surgery on Reproductive Outcomes: the Impact According to the Diagnosis of Polycystic Ovarian Syndrome and Surgical Procedures

Casals, Gemma; Andreu, Alba; Barral, Yasmina; Ventosa, S.; Redondo, Miriam; Ibarzábal, Ainitze; Manau, Dolors; Carmona, Francisco; Vidal, Josep; Flores, Lílliam

doi:10.1007/s11695-021-05297-x

Cited by 15 publications

(20 citation statements)

References 29 publications

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“…From a total of 879 records, 192 were excluded due to duplication, 629 were excluded by title and abstract screening, and 44 were excluded after a further detailed review. A total of 14 studies conducted on 501 obese patients with PCOS were eligible and were in the meta-analysis ( 10 , 18 – 30 ). After the quality assessment, no study was excluded because of lack of reliability ( Supplementary Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies reported at least 6-month follow-up outcomes of abnormal menstruation ( 10 , 19 , 21 , 24 – 30 ). Heterogeneity was considerable among studies (I 2 = 66%, P=0.002); thus, the random-effects model was used for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies reported BMI among 414 patients ( 10 , 18 , 19 , 21 , 23 – 27 , 29 , 30 ). There was considerable heterogeneity detected (I 2 = 95%, P<0.00001), and the meta-analysis was performed with the random-effects model.…”

Section: Resultsmentioning

confidence: 99%

“…However, obesity, a frequent feature among PCOS patients (60-70%), has a major contribution to the aggravation of insulin resistance ( 9 ). Studies have suggested that weight loss improves reproductive and metabolic dysfunction and reduces the risk of diabetes and cardiovascular disease ( 10 , 11 ). Currently, lifestyle management targeting weight reduction is the first-line treatment for PCOS ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

“…Its therapeutic effects include resolution of type 2 diabetes, hypertension, hyperlipidemia, cardiovascular disease, and obstructive sleep apnea ( 13 , 14 ). In addition, a few small-scale studies have indicated the positive effects of metabolic surgery on PCOS, including improvement of abnormal menstruation, hirsutism, fertility, and associated metabolic problems ( 10 , 15 ). These findings suggested that metabolic surgery could be a potential treatment for PCOS; therefore, it has been recommended as an experimental therapy ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%