Obesity is an escalating problem in all age groups and it is observed to be more common in females than males. About 25% of women meet the criteria of obesity and one-third of them are in the reproductive age. Because morbid obesity requiring surgical treatment is observed with increasing frequency, surgeons and gynecologists are undergoing new challenges. It is not only a matter of women’s health and their quality of life but also proper development of the fetus, which should be a concern during bariatric treatment. Therefore complex perinatal care has to be provided for morbid obesity patients. The paper reviews pregnancy and fertility issues in bariatric surgery patients. 1. Incidence and Implications of Obesity Obesity defined as body mass index (BMI) of 30？kg/m2 or greater is an emerging health problem in the modern world, above all in industrial countries. It is becoming the main cause of preventable morbidity and mortality. Public health research has identified obesity as the second leading cause of death in America, just after tobacco-related diseases [1]. It is estimated that about 27% of population in the United States is obese [2]. This problem is escalating in all age groups, with a greater occurrence in females. About 25% of women meet the obesity criteria and one-third of them are in the reproductive age [3]. Obese women are at higher risk of associated diseases. Some studies have demonstrated that BMI increase is associated with higher miscarriage rate and lower mature oocyte yield [4]. In other emphases that fetal evaluation during pregnancy is difficult. Furthermore, morbidly obese pregnant women are endangered by high risk pregnancy, delivery, and postpartum complications [2] (Table 1). Table 1: Maternal risks associated with obesity. The bariatric surgery is advisable only for carefully selected, morbidly obese patients when conservative methods of weight reduction were unsuccessful [5]. 2. Pregnancy after Bariatric Surgery Pregnancy after surgical bariatric treatment appears to be a complex medical challenge [6]. It is necessary to inform women about supplementation and additional laboratory tests and possible negative influence of bariatric surgery on their future pregnancies. It is suggested that women after bariatric surgery who become pregnant need to be followed up by a group of specialists including a nutritionist, an educated nursing staff, an obstetrician, an endocrinologist, an internal medicine specialist, and a bariatric surgeon [7]. Considerations on pregnancy following bariatric surgery are dependent straightly on the
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