{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:40:04Z","timestamp":1792885204359,"version":"4.5.0"},"reference-count":122,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Obesity is associated with menstrual dysfunction, anovulation, and infertility, particularly in women with polycystic ovary syndrome (PCOS). This narrative review summarizes evidence on the effects of bariatric surgery [focusing on sleeve gastrectomy (SG) Roux-en-Y gastric bypass (RYGB)] on female reproductive function and fertility outcomes. Developed according to SANRA (Scale for the Assessment of Narrative Review Articles) principles, a structured search of PubMed, Scopus, and Web of Science (English language; inception\u201330 September 2025) was conducted, using fertility-related terms (e.g., fertility, ovulation, IVF\/ART, AMH, PCOS, pregnancy, live birth, time to conception) combined with bariatric surgery terms (SG\/VSG, RYGB, metabolic\/bariatric surgery, and weight loss surgery). Guidelines from IFSO, BOMSS, and ASMBS were also reviewed. Findings were synthesized narratively. Across mainly observational studies, bariatric surgery is associated with improved menstrual regularity, increased ovulation, reduced hyperandrogenism, and improved insulin sensitivity, with higher conception rates reported after substantial weight loss. AMH responses are inconsistent across studies and their clinical significance remains uncertain. SG and RYGB appear to improve fertility-related outcomes in women with obesity. Programming of pregnancy and nutritional monitoring are critical. In conclusion, long-term, standardized reproductive endpoints are needed to clarify bariatric surgery-associated effects during pregnancy.<\/jats:p>","DOI":"10.3390\/ijms27083665","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:01:22Z","timestamp":1776686482000},"page":"3665","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effects of Bariatric Surgery on Female Fertility: A Narrative Review"],"prefix":"10.3390","volume":"27","author":[{"given":"Maria","family":"Iliopoulou","sequence":"first","affiliation":[{"name":"Unit of Endocrinology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theoharis","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Iaso Maternity Hospital, IVF Unit Institute of Life\u2014IASO, 15123 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4967-2505","authenticated-orcid":false,"given":"Makarios","family":"Eleftheriadis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-3275","authenticated-orcid":false,"given":"George","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"},{"name":"Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Valsamakis","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"},{"name":"Department of Obstetrics and Gynecology, Aretaieio University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"ref_1","unstructured":"NCD Risk Factor Collaboration (NCD-RisC), Bentham, J., Di Cesare, M., Bilano, V., Bixby, H., Zhou, B., Stevens, G.A., Riley, L.M., Taddei, C., and Hajifathalian, K. 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