Obesity Clinical Trial
Official title:
The Effect of Weight Reduction Surgery on Ovarian Function in Obese Anovulatory Patients
This study will investigate the role of weight reduction surgery on the reproductive performance of obese women with ovulation problems. It is hypothesized that surgery offered when other methods of weight reduction have failed, may help restore ovulation.
We aim to recruit 30 patients suffering from chronic anovulation, with a body mass index of
35 or more, who failed to achieve weight reduction with other methods such as orlistat,
metformin, diet and exercise.
Patients will be approached by one of the investigators in the infertility clinics and the
assisted conception unit of the Royal Hallamshire hospital. Consent will be obtained by one
of the designated investigators. The consent form has been designed in accordance with the
guidelines of the central office for research and ethics committees (COREC). A patient
information leaflet will be supplied and has been designed according to the COREC
guidelines.
Patients will have a baseline history, clinical examination, hormonal profile (FSH/LH,
fasting Insulin/glucose ratio, androgen profile, day 21 serum progesterone, serum leptin and
ghrelin levels) ultrasound examination (ovarian volume and antral follicle count), including
Doppler blood flow study (ovarian stromal velocity).
Patients will be offered laparoscopic gastric bypass surgery by Mr Roger Ackroyd, in line
with the current recommendation for gastric surgery according to NICE guidelines i.e.
patients with a BMI over 40 or a BMI over 35 with at least one co-morbidity. Patients will
be reviewed monthly for six months. At each visit the following will be recorded:
1. Weight, menstrual diary.
2. Hormonal profile (FSH/LH, fasting Insulin/glucose ratio, androgen profile, day 21 serum
progesterone, serum leptin and ghrelin levels).
3. Doppler of ovarian stroma (Pulsitility index, Peak velocity), ovarian volume and antral
follicle count
4. Review of symptomatology especially androgenic symptoms.
End point:
Completion of six months follow up.
;
Time Perspective: Prospective
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