The Role of Bariatric Surgery in Enhancing Fertility among Women with Significant Obesity

Objectives Bariatric surgery is a long-term treatment for obesity that leads to significant weight loss that impacts reproductive health. This study explored how bariatric surgery affects pregnancy rates post-surgery. Methods This retrospective study was conducted at Bahrain Defense Force Hospital in 2019–2022 and included 310 women of reproductive age who had bariatric surgery before planning pregnancy. Data were analyzed using standard statistical tests, with p < 0.05 considered significant. Result Of 310 patients who underwent bariatric surgery, 35.8% (111 patients) achieved pregnancy. Those with successful pregnancies had higher pre-surgery weight and body mass index (BMI) and a greater BMI drop (35.3%) compared to non-pregnant patients (29.4%). Receiver operating characteristic (ROC) curve analysis indicated that a BMI-loss cutoff of 34.6% was associated with pregnancy (sensitivity 61%, specificity 64%). Logistic regression was performed according to this cutoff value to exclude any other contributing factors, including age ≤ 35 years, BMI ≤ 30, and use of artificial reproductive therapy (ART) to achieve pregnancy; the analysis results were insignificant for all of the factors. Simple linear regression showed no correlation between pre-surgery weight, total weight loss, percentage of BMI loss, and the time required to achieve pregnancy after bariatric surgery ( P  = 0.95, P  = 0.25, and P  = 0.72). Conclusion Higher pre-surgery BMI and greater BMI loss were linked to higher pregnancy success after bariatric surgery.