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A randomized controlled trial (BAMBINI) sought to determine whether bariatric surgery could outperform medical care in improving ovulation rates for women with polycystic ovary syndrome (PCOS), obesity, and oligomenorrhoea (irregular periods) or amenorrhoea (no periods at all).
In women suffering from PCOS and obesity, bariatric surgery is superior to medical treatment in boosting spontaneous ovulation rates.
A randomized controlled trial (BAMBINI) sought to determine whether bariatric surgery could outperform medical care in improving ovulation rates for women with polycystic ovary syndrome (PCOS), obesity, and oligomenorrhoea (irregular periods) or amenorrhoea (no periods at all).
Overall, 80 PCOS-affected women with a body mass index (BMI) of 35 kg/m² or higher were included. Participants (median age 31 years) were recruited from two specialized obesity management centers and through social media. They were randomized to get either vertical sleeve gastrectomy (surgical group) or a combination of behavioral interventions and medical care (medical group). Using weekly serum progesterone levels, the number of biochemically validated ovulations over 52 weeks was ascertained (key endpoint).
A total of 40 volunteers were assigned to each group, with 7 dropouts from the medical group and 10 from the surgical group. The surgical group experienced a median of 6 ovulations (interquartile range [IQR] 3.5–10), as opposed to just 2 (IQR 0–4) in the medical group. Those in the surgical group exhibited 2.5 times higher spontaneous egg release rates as opposed to those in the medical group (incidence rate ratio 2.5).
Patients treated with bariatric surgery exhibited greater improvements in psychological health, quality of life, biochemical hyperandrogenism, anthropometrics, and cardiometabolic risk factors. However, no vital differences were noted between the groups in clinical hyperandrogenism. While more complications were reported in the surgical group (66.7%) compared to the medical group (30.0%), these complications did not lead to long-term harm. Importantly, there were no treatment-linked deaths.
Vertical sleeve gastrectomy was more beneficial than medical therapy at inducing spontaneous ovulation in women with PCOS, obesity, and irregular or absent periods. These results highlight bariatric surgery as a potential key intervention for improving fertility prospects in women facing both obesity and reproductive health issues.
Lancet
Bariatric surgery for spontaneous ovulation in women living with polycystic ovary syndrome: the BAMBINI multicentre, open-label, randomised controlled trial
Suhaniya N S Samarasinghe et al.
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