Thursday, December 18, 2008

Gastric banding helps big women have babies


Weight-loss surgery can help obese women conceive babies more easily through IVF, according to research showing lap bands can partially restore fertility. Very overweight Australian women have been increasingly taking up the option of bariatric surgery after failing to fall pregnant naturally, and a new study from the US backs the move.
A team from Washington University reviewed the records of five obese women who underwent bariatric surgery followed by IVF.Three of the women got pregnant after just one treatment cycle and delivered healthy full-term infants, while the other two women are still pregnant after requiring three cycles.
Lead researcher Dr Beth Lewkowski told a fertility conference in San Francisco that all five women had been infertile for two to 10 years before the surgery. Dr Anne Clark, a fertility specialist in Sydney, said while no such study had been completed in Australia there had been a steep increase in women seeking weight-loss surgery to improve fertility.
Obese women undergoing fertility treatment generally have less success, require higher doses of medication to help get them to ovulate, and have a higher miscarriage rate.
"We have been able to show that women with a body mass index (BMI) under 35 kilograms can dramatically improve their chances of pregnancy with just seven kilos of weight loss," Dr Clark said.
"But women who are very obese, with a BMI of 40 or more, need to lose even more weight to have the same success, and that can be impossible for some women to do naturally.
"It's in these cases women get surgery, and we definitely notice it helps."
Professor Rob Norman, director of the Research Centre for Reproductive Health at the University of Adelaide, said that gastric banding, in which a rubber band is surgically wrapped around the stomach, was getting the best results.
"It's something we are going to see more and more among very big people, and it's clear there a big benefits for the women and for their babies," Prof Norman said from San Francisco.
About 14,000 Australians are expected to get lap band surgery this year, with guidelines requiring patients to have a BMI over 30 and have failed to lose weight by other means. About 80 per cent of patients were female, but only a very small proportion sought surgery primarily to aid pregnancy, obesity experts say.