Influence of sleeve gastrectomy on menstrual function and ovarian reserve in patients with obesity

BACKGROUND: Obesity is associated with development of menstrual disorders (MD), a decrease in ovarian reserve and infertility. Treatment of obesity contributes to the normalization of the reproductive function of women. Bariatric surgery is known to be the most effective method of obesity treatment, while the most common intervention is the sleeve gastrectomy (SG), the effect of which on menstrual function and ovarian reserve has not been studied enough.AIM: To study the effect of SG on menstrual function and ovarian reserve in obese women of reproductive ageMATERIALS AND METHODS: Female patients with BMI ≥ 35 kg/m2 aged 25 to 36 years were examined. At baseline and 6 months after SG, the characteristics of menstrual function were determined, BMI and HOMA-IR were calculated, and the level of anti-Müllerian hormone (AMH) was measured. The obtained parameters were compared in patients with and without MDRESULTS: . In all patients, 6 months after SG, there was a decrease in BMI: 30.1 kg/m2 (29.3–32.1) and 39.3 kg/m2 (37.3–41.0) (p<0.001), HOMA -IR: 5.0 (4.1–5.9) and 2.8 (2.1–3.2) (p=0.001). The initial level of AMH in patients with MD (n=12) was lower than in patients with normal menstrual function (n=10): 2.4 ng/ml (1.9–2.0) and 3.2 ng/ml (2.6–4.2), respectively (p=0.032). A significant increase in AMH levels occurred only in the group of patients with MD (p=0.04). MD remained only in 3 women.CONCLUSION: SG in patients of reproductive age with obesity is associated with the normalization of menstrual function and an increase in AMH, as well as a decrease in the degree of insulin resistance.