TY - JOUR
T1 - Conception rates and contraceptive use after bariatric surgery among women with infertility
T2 - Evidence from a prospective multicenter cohort study
AU - Menke, Marie N.
AU - King, Wendy C.
AU - White, Gretchen E.
AU - Gosman, Gabriella G.
AU - Courcoulas, Anita P.
AU - Dakin, Gregory F.
AU - Flum, David R.
AU - Orcutt, Molly J.
AU - Pomp, Alfons
AU - Pories, Walter J.
AU - Purnell, Jonathan Q.
AU - Steffen, Kristine J.
AU - Wolfe, Bruce M.
AU - Yanovski, Susan Z.
N1 - Funding Information:
The Longitudinal Assessment of Bariatric Surgery-2 was funded by a cooperative agreement by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Grant numbers: Data Coordinating Center—U01-DK066557; Columbia-Presbyterian—U01-DK66667 (in collaboration with Cornell University Medical Center CTSC, Grant UL1-RR024996); University of Washington—U01-DK66568 (in collaboration with CTRC, Grant M01RR-00037); Neuropsychiatric Research Institute—U01-DK66471; East Carolina University —U01-DK66526; University of Pittsburgh Medical Center — U01-DK66585 (in collaboration with CTRC, Grant UL1-RR024153); Oregon Health & Science University — U01-DK66555 . M.M. was funded under NIH K12 HD 063087.
Funding Information:
The Longitudinal Assessment of Bariatric Surgery-2 was funded by a cooperative agreement by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Grant numbers: Data Coordinating Center—U01-DK066557; Columbia-Presbyterian—U01-DK66667 (in collaboration with Cornell University Medical Center CTSC, Grant UL1-RR024996); University of Washington—U01-DK66568 (in collaboration with CTRC, Grant M01RR-00037); Neuropsychiatric Research Institute—U01-DK66471; East Carolina University—U01-DK66526; University of Pittsburgh Medical Center—U01-DK66585 (in collaboration with CTRC, Grant UL1-RR024153); Oregon Health & Science University—U01-DK66555. M.M. was funded under NIH K12 HD 063087.
Funding Information:
A.C. has received research grants from Covidien, Ethicon, Nutrisystem, and PCORI, and consultant fees from Apollo Endosurgery. D.F. has had an advisor role with Pacira Pharmaceuticals, has provided expert testimony for Surgical Consulting LLC, and has received travel expenses from Patient Centered outcomes research institute. W.P. has received research grants from J & J, Janssen Pharmaceuticals. B.W. has received consultant fees from Enteromedics. A.P. is a consultant and speaker for Medtronic and Ethicon and WL Gore and Associates. The other authors did not report any potential conflicts of interest.
Publisher Copyright:
© 2019 American Society for Bariatric Surgery
PY - 2019/5
Y1 - 2019/5
N2 - Background: Lack of prospective trials have resulted in a dearth of information regarding postbariatric surgery conception rates in women with a preoperative history of infertility. Objective: To examine associations between preoperative history of infertility and postbariatric surgery conception. Setting: A multicenter cohort study at 10 United States hospitals (2006–2009). Methods: Participants completed a preoperative reproductive health questionnaire, with annual postoperative assessments for up to 7 years until January 2015. This report was restricted to women 18- to 44-years old with no history of menopause, hysterectomy, or hormone replacement therapy. The primary outcomes were postoperative (0 to <90 mo) conception rate, early conception rate (0 < 18 mo), and postoperative unprotected intercourse with a male partner while not trying to conceive. Results: Of 740 eligible women, 650 (87.8%) provided required responses. Median interquartile range (IQR) preoperative age was 34 (30–39) years and follow-up was 6.5 (5.9–7.0) years. Nulliparous women with a preoperative history of infertility represented 8.0% (52/650) of the total cohort, 63.5% (33/52) of whom had never conceived. Compared with women without this history, these women had a higher postoperative conception rate (121.2 [95% confidence interval (CI), 102.3–143.5]/1000 versus 47.0 [95%CI, 34.2–62.9]/1000 woman-yr; P < .001), early conception rate (115.4 [95%CI, 96.1–138.5]/1000 versus 33.9 [95%CI, 23.6–47.1]/1,000 woman-yr; P < .01), and a higher risk of unprotected intercourse (ARR 1.48 [95% CI, 1.14-1.90], P = 0.003). Conclusion: After bariatric surgery, preoperative history of infertility and nulliparity was associated higher conception rates and unprotected intercourse.
AB - Background: Lack of prospective trials have resulted in a dearth of information regarding postbariatric surgery conception rates in women with a preoperative history of infertility. Objective: To examine associations between preoperative history of infertility and postbariatric surgery conception. Setting: A multicenter cohort study at 10 United States hospitals (2006–2009). Methods: Participants completed a preoperative reproductive health questionnaire, with annual postoperative assessments for up to 7 years until January 2015. This report was restricted to women 18- to 44-years old with no history of menopause, hysterectomy, or hormone replacement therapy. The primary outcomes were postoperative (0 to <90 mo) conception rate, early conception rate (0 < 18 mo), and postoperative unprotected intercourse with a male partner while not trying to conceive. Results: Of 740 eligible women, 650 (87.8%) provided required responses. Median interquartile range (IQR) preoperative age was 34 (30–39) years and follow-up was 6.5 (5.9–7.0) years. Nulliparous women with a preoperative history of infertility represented 8.0% (52/650) of the total cohort, 63.5% (33/52) of whom had never conceived. Compared with women without this history, these women had a higher postoperative conception rate (121.2 [95% confidence interval (CI), 102.3–143.5]/1000 versus 47.0 [95%CI, 34.2–62.9]/1000 woman-yr; P < .001), early conception rate (115.4 [95%CI, 96.1–138.5]/1000 versus 33.9 [95%CI, 23.6–47.1]/1,000 woman-yr; P < .01), and a higher risk of unprotected intercourse (ARR 1.48 [95% CI, 1.14-1.90], P = 0.003). Conclusion: After bariatric surgery, preoperative history of infertility and nulliparity was associated higher conception rates and unprotected intercourse.
KW - Bariatric surgery
KW - Conception
KW - Contraception
KW - Infertility
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U2 - 10.1016/j.soard.2018.12.026
DO - 10.1016/j.soard.2018.12.026
M3 - Article
C2 - 30981592
AN - SCOPUS:85064275576
SN - 1550-7289
VL - 15
SP - 777
EP - 785
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 5
ER -