Roux-en-Y gastric bypass ameliorates polycystic ovary syndrome and dramatically improves conception rates: a 9-year analysis

Jamal, Mohammad; Günay, Yusuf; Capper, Alyssa; Eid, Anas; Heitshusen, Debi; Samuel, Isaac

doi:10.1016/j.soard.2011.09.022

Cited by 100 publications

(73 citation statements)

References 19 publications

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“…Weight loss following bariatric surgery leads to improved sex hormone profiles and improvement of metabolic and hormonal changes associated with polycystic ovarian syndrome (PCOS), thereby increasing fertility [92,93,94]. For instance, Legro et al [93] demonstrated follicular phase shortening, reduction in android fat and improved female sexual function in women post-RYGB.…”

Section: Pregnancy After Bariatric Surgerymentioning

confidence: 99%

“…For instance, Legro et al [93] demonstrated follicular phase shortening, reduction in android fat and improved female sexual function in women post-RYGB. A study looking at PCOS following RYGB demonstrated improvements in hirsutism, type 2 diabetes mellitus and fertility [94]. Following bariatric surgery, fertility can rapidly improve, even in previously anovulatory women [95].…”

Section: Pregnancy After Bariatric Surgerymentioning

confidence: 99%

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Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.

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Section: Pregnancy After Bariatric Surgerymentioning

confidence: 99%

Section: Pregnancy After Bariatric Surgerymentioning

confidence: 99%

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

et al. 2017

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“…Of the 19 remaining studies, 5 were excluded due to inadequate outcome measures and 1 was excluded because the number of female study subjects was unknown. A total of 13 primary studies (10 full manuscripts and 3 abstract studies) consisting of no randomized controlled trials, 13 case-series [11][12][13][14][15][16][17][18][19][20][21][22][23], and no case reports were selected for review and meta-analysis ( Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

The Impact of Bariatric Surgery on Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis

Skubleny

Switzer

Gill³

et al. 2015

OBES SURG

134

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Bariatric surgery has been proven to be a successful management strategy for morbid obesity, but limited studies exist on its effect on polycystic ovary syndrome (PCOS). A comprehensive search of electronic databases was completed. Meta-analysis was performed on PCOS, hirsutism, and menstrual irregularity outcomes following bariatric surgery. Thirteen primary studies involving a total of 2130 female patients were identified. The incidence of PCOS preoperatively was 45.6 %, which significantly decreased to 6.8 % (P < 0.001) and 7.1 % (P < 0.0002) at 12-month follow-up and study endpoint, respectively. The incidences of preoperative menstrual irregularity and hirsutism both significantly decreased at 12-month and at study end follow-up. Bariatric surgery effectively attenuates PCOS and its clinical symptomatology including hirsutism and menstrual irregularity in severely obese women.

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“…Two additional studies published in the last years found that bariatric surgery may have an important albeit not universal benefit on hirsutism in massively obese women with PCOS. One study (96) found that in 20 women with severe obesity and PCOS, a Roux-en-Y gastric bypass significantly ameliorated menses and conception rates in most, and resolved hirsutism in 29% of them. A second study (97) reviewed the outcomes of 24 massively obese women diagnosed with PCOS who had undergone elective laparoscopic gastric bypass surgery and found that all but one were hirsute before surgery but 12 (52%) had complete resolution at a mean follow-up of 8G2.3 months, six (25%) had moderate resolution at a mean of 21G18 months, three had minimal resolution at 34G14 months and, finally, two women reported no change in their hirsutism at 32G7 months.…”

Section: Bariatric Surgerymentioning

confidence: 99%

THERAPY OF ENDOCRINE DISEASE: Treatment of hirsutism in the polycystic ovary syndrome

Pasquali

Gambineri

2014

European Journal of Endocrinology

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Hirsutism is a common medical complaint among women of reproductive age, and it affects the majority of women with the polycystic ovary syndrome (PCOS). Increased rate of androgen production and its availability in tissue represent the main pathophysiological mechanisms responsible for hirsutism. In addition, androgens may be generated de novo in the hair follicle; therefore, circulating androgen levels do not quantify the real exposure of the hair follicle to androgens, as a quota is locally generated. Hirsutism is a clinical sign and not a disease in itself; its presence does not therefore necessarily require treatment, particularly in mild-to-moderate forms, and when an affected woman does not worry about it. Physicians should decide whether hirsutism is to be treated or not by evaluating not only the severity of the phenomenon but also the subjective perception of the patient, which does not necessarily correspond to the true extent of hair growth. In any case, a physician should manage a woman with hirsutism only on the basis of a diagnosis of the underlying cause, and after a clear explanation of the efficacy of each therapeutic choice. Cosmetic procedures and pharmacological intervention are commonly used in the treatment of hirsutism and are discussed in this paper. Importantly, there are different phenotypes of women with hirsutism and PCOS that may require specific attention in the choice of treatment. In particular, when obesity is present, lifestyle intervention should be always considered, and if necessary combined with pharmacotherapy.

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Roux-en-Y gastric bypass ameliorates polycystic ovary syndrome and dramatically improves conception rates: a 9-year analysis

Cited by 100 publications

References 19 publications

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

The Impact of Bariatric Surgery on Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis

THERAPY OF ENDOCRINE DISEASE: Treatment of hirsutism in the polycystic ovary syndrome

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