Impact of Bariatric Surgery on Serum AMH Level and Fertility and Reproductive Condition in Obese Women

Background & Objective: Bariatric surgery may lead to a decline in AMH level at intervals of 3 and 6 months after surgery. However, there is a debate on whether this decline is due to a temporary starvation phase and shift in metabolism or if BS has an impact on ovarian reserve. The present study was conducted with aim to evaluate changes in serum anti-mullerian hormone (AMH) levels, fertility and metabolic conditions in severely obese women at the reproductive age after laparoscopic sleeve gastrectomy.Materials & Methods: This prospective cohort study focused on severely obese women aged 18-40 years at reproductive age with BMI 36 to 42 kg/m2 who were referred to Tanta University Hospital for bariatric surgery (BS). Before and 6 months following the surgery, the levels of AMH and other hormones (including follicular stimulating hormone (FSH), luteinizing hormone (LH), free testosterone, sex hormone binding globin (SHBG), and fasting insulin) was re-evaluated.Results: Among 64 women who were enrolled in the study, 50 women completed the 6-month follow-up. There was a significant difference in terms of weight, BMI, fasting insulin level, and regular menstrual pattern before and after 6 months following surgery. There was a significant effect of weight reduction on the occurrence of spontaneous ovulation, BMI parameter, and the level of change in BMI, regular menstrual cycle, while the other fertility related parameters, although improved, failed to show any significant relationship. Additionally, 20 cases (40%) had a spontaneous ovulation after a 6-month follow-up after BS.Conclusion: Obese females' reproductive abilities improved after bariatric surgery and weight loss.