The Impact of Sleeve Gastrectomy on Females With Polycystic Ovarian Syndrome From 2018 to 2020 in Riyadh, Saudi Arabia: A Prospective Study

Background: Obesity is one of the most common risk factors for polycystic ovarian syndrome (PCOS). Reducing body weight has shown to improve the symptoms of PCOS; however, it is still unclear if the surgical treatment of obesity can have better outcomes to control obesity and improve PCOS. Objective: This study aims to identify the impact of sleeve gastrectomy on PCOS symptoms in Riyadh, Saudi Arabia with a comparison of other weight reduction surgeries. Design and Setting: This is a prospective study that included patients with PCOS who had weight reduction surgeries between 2018 and 2020, in Riyadh, Saudi Arabia. Using an online questionnaire, demographic data will be collected and information about menstruation, abortion, polycystic ovarian syndrome, and bariatric surgeries (if any). Data analysis was done through Statistical Package for the Social Sciences (SPSS) v26 (IBM Corp., Armonk, NY, USA). Results: Ninety-nine female patients responded to this survey, all of whom had PCOS; 57.6% of these patients had a positive family history of PCOS. The most-reported PCOS symptoms were irregular menses (63.6%) and weight gain (53.5%), while 9.1% were asymptomatic. 52.5% were obese, and 91.1% underwent gastric sleeve surgery to treat their obesity. 41.4% of the females had a regular cycle before the operation, which increased to 60.6% after the operation; 48.5% had a normal flow before the operation, which increased to 61.6% after the operation. 15.2% conceived once before the operation, which increased to 16.2% after the operation. 11.1% had one abortion before surgery, which decreased to 7.1% after surgery. 55.6% observed an improvement in their PCOS symptoms after surgery, and 47.5% found that their fertility improved according to their own perception. Females with a positive family history of PCOS had a higher prevalence of PCOS (p-value <0.001). Also, females 30-39 years old are significantly more likely to have PCOS (p-value <0.001). The incidence of abnormal menstrual flow and irregular menstrual cycle was seen significantly more in PCOS patients than non-PCOS (p-value=0.019 and 0.004, respectively). PCOS symptoms and fertility significantly improved after surgery (p-value=0.031 and 0.043, respectively). Conclusion: Sleeve gastrectomy can lead to significant improvement in fertility and symptoms of PCOS. It can also reduce the incidence of abortion. Other surgical techniques should be investigated.