Gastric banding, odds of conceiving, and safety of pregnancy: physicians' advice especially welcome

[supportivehusband1 0]

My spouse is age 36 and at 6ft and 25st (BMI 47.5; EBW = 49pct of current weight, making her nearly 98pct over ideal) has decided that she wants gastric banding (she's not interested in more invasive and irreversible procedures such as VSG and any sort of bypass or switch). We're currently trying to conceive our first child (we're very late in starting, we know) but have had to live separately for work reasons until recently and so have only recently had the opportunity for a consistent effort. For what it's worth (and with apologies for any oversharing), she has regular menses and shows none of the usual signs of PCOS.

Our overall question, on which we'd be especially grateful for one or more physicians' advice, is this: What timing of her procedure would maximize our odds of conceiving?

Specifically, would it be most effective to

a) have her WLS first, spend any required waiting period before pregnancy (see below) losing weight and then resume trying to conceive;

keep trying for a few more cycles to see whether we can easily conceive as is, then have her WLS and wait for any required time and then resume trying with what we hope are improved odds;

c) postpone her WLS entirely until our window of opportunity has for practical purposes closed (call it age 40?) and keep trying with our current odds

or

d) something in between (and in that event, what)?

Also, what if anything would she need to have done with the band before trying to conceive?

- We've heard from some sources that she will need to wait for a year and from others that she will need to wait for two years before trying to conceive, but other sources don't mention this warning. Do we need to wait, and if so, for how long?

- If there's a necessary wait if the band is in place and filled but we want to resume trying earlier, is removing the Fluid from the band enough to ensure proper nourishment for the foetus or will the band need to be removed entirely?

- - If band removal is required, would the removal procedure (including both the physical removal itself and whatever anaesthesia is necessary) pose a significant risk of harm to the foetus?

- If whatever needs to be done can be done without harm to the foetus, would regular testing (at least once per week) enable us to find out and have the deflation or removal performed while the foetus is still small enough and its nutritional needs low enough that we can have the band removed/deflated early enough to avoid interfering with its growth and development? In other words, is it safe with proper monitoring and prompt action for her to have her procedure and fill now and for us to continue trying to conceive even as she begins to lose weight (and gain fertility)?

If she has her procedure before our window of opportunity closes but she needs to have the band removed or deflated before conceiving, what would be the optimal length of time to leave it in/filled (maximizing gains from increased likelihood at any given time less losses from giving up the time when it's left in)? Because the maths seems horrendous (something about maximizing the value of the integral of the probability-versus-time function when both the x-range over which the integral is calculated and the y-value at any given time vary with how long the band is left in/filled, in the y-value's case only indirectly because it's really a matter of her weight and her weight is what varies with how long it's left in), we certainly don't expect a precise answer; we'd be grateful for just a general figure.

Thank you for your help!