European Journal of Molecular & Clinical Medicine

Background: There are limited data about the impact of bariatric procedures on androgen milieu,
sex hormone binding globulin (SHBG) and free androgen index (FAI) in obese women with
polycystic ovary syndrome. Since the changes in these levels can amenably affect fertility in this
group of patients, it is necessary to study such effects.
Objective: to study the impact of bariatric surgery on androgen hormone levels, SHBG and FAI in
obese women with polycystic ovary syndrome (PCOS) and infertility.
Study design: A cohort study. Patients and Methods: 36 obese women with PCOS and infertility,
attending at Zagazig University Hospitals, outpatient clinic, who underwent bariatric surgery
(gastric sleeve or gastric bypass) for excess weight loss. Evaluation of serum free and total
testosterone levels, Sex hormone binding globulin (SHBG) by ELISA and calculation of free
androgen index (FAI), before operation and compared to 6 months and 1 year after operation.
Results: Before bariatric surgery, all women had abnormally high levels of free and total
testosterone, low sex hormone binding globulin, and high free androgen index. After surgery,
levels of free and total testosterone dropped significantly, with a rise in SHBG and a significant
drop in FAI (P < 0.001) 6-month and 1-year after bariatric procedure.
Conclusion: excess weight loss by bariatric surgery leads to normalization of androgenic milieu,
and improves SHBG and FAI in PCOS patients.