The Potential Role of Intragastric Balloon in the Treatment of Obese-Related Infertility: Personal Experience

Abstract

The prevalence of people who are overweight or obese has increased dramatically in high-income countries over the past 20 years. There is a strong association between obesity and infertility, and weight loss can result in increased fecundity in obese women. The aim of this study is to demonstrate the potential role of intragastric balloon in the treatment of obese-related infertility. This is a retrospective study. A chart review of 27 obese women seen between September 2003 and July 2008 was performed. They all presented with the diagnosis of infertility and had undergone endoscopic intragastric balloon positioning. Among these women who tried unsuccessfully to become pregnant before weight loss, 15 became pregnant afterward. The pregnancies proceeded without complications and ended with live births. An improvement in the fertility status after weight loss has been described, although data on fertility after weight loss following bariatric surgery are still limited. The results obtained in our experience are not different from data reported in literature for bariatric surgery. Therefore, balloon treatment might be effective in young infertile obese women who wish to become pregnant.

Use of Intragastral Balloon and Increase in Fertility: Case Report

“…Many obese women are hyperinsulinemic and, therefore, have endocrine profiles characteristic of PCOS, that is, peripheral insulin resistance leads to a reduction in SHBG (carrier globulin of sexual steroids). Thus, there will be a greater free fraction of estrogen and androgen, inhibiting the pulsating release of GnRH, deregulating ovulation [3]. In response there is an increase in sex steroids like testosterone, dihydrotestosterone and androestenediol.…”

“…The success of bariatric surgery and the intragastric balloon is due to the fact that it allows for greater weight loss and longer weight maintenance [3].…”

“…Insulin resistance causes an altered release of progesterone, which may inhibit normal function of the corpus luteum. In addition, low levels of leptin may impair the early development of the embryo and impair the trophoblast invasion [3].…”

“…Obesity also impairs endometrial receptivity in embryo implantation and growth [3]. In addition to impairing spontaneous conception, a high BMI (body mass index) may impair the probability of reaching pregnancy with assisted reproductive technology [12].…”

“…Infertility is defined as the inability of a couple to achieve pregnancy after 1 year of unprotected regular intercourse or the inability of a woman to conduct a pregnancy until the birth of a living being or with no assisted reproductive technology. There is a strong association between obesity and infertility, and weight loss may result in increased fecundity in obese women [3].…”