Pregnancy Following Metabolic-Bariatric Surgery in a Woman With Potential Premature Ovarian Failure: A Case Report

Premature ovarian insufficiency (POI) is associated with decreased ovulation in the precursor stage which leads to ovarian failure in the end stage. Metabolic-bariatric surgery (MBS) can improve women's reproductive status, including the release of sex hormones, ovulation, and fertilization. Here, we report a spontaneous pregnancy following MBS despite potential ovarian insufficiency. A 38-year-old woman with severe obesity underwent three cycles of assisted reproduction that were not successful. Oligomenorrhea ≥ 4 months, laboratory indices, and previous poor ovarian response approved the diagnosis of diminished ovarian reserve and could be considered as the precursor stage of POI. Then a gastric bypass was applied, and a spontaneous pregnancy occurred in the 22^nd month after surgery, with 45.80% reduction in body mass index. MBS in women with obesity and idiopathic ovarian insufficiency may increase the chance of spontaneous ovulation and successful pregnancy.