THE IMPACTS OF BARIATRIC SURGERY ON THE RESTORATION OF FERTILITY IN OBESE PATIENTS

Abstract

Introduction: Due to the multiple and complex changes in hormonal physiology caused by obesity, it is associated with infertility in men and women. In this context, bariatric surgery, when well indicated and carried out judiciously, leads to substantial weight loss that promotes an improvement in menstrual irregularities and metabolic profile, thus increasing the fertility of these patients. Objectives: The aim of this study is to address the relationship between bariatric surgery and its possible effects on the process of restoring fertility in men and women. Methods: This is an integrative review based on articles published in the ScieELO and Pubmed databases in English and Portuguese between 2015 and 2023, using the descriptors Infertility, Bariatric Surgery, Reproductive Health and Obesity. The inclusion criteria were studies that correlated bariatric surgery and fertility in men and women. Studies not available in full were excluded. Results: Weight loss after bariatric surgery led to an increase in testosterone levels and a reduction in estradiol levels in men, as well as an improvement in sperm viability and volume, with more significant results than in patients not undergoing surgical treatment. In women, increased levels of sex hormone binding globulin (SHBG), reduced testosterone levels and improved regularity of menstrual cycles were observed. There was also a reduction in the number of patients meeting the Rotterdam criteria for Polycystic Ovary Syndrome (PCOS). Most of the included studies revealed positive results regarding conception and pregnancy. Conclusion: Bariatric surgery is an effective method of weight loss, demonstrating improvement in infertility in obese patients. However, more studies are needed to establish in practice the indications for this operation in this context and to determine whether different surgical techniques have different results for this purpose.