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 - 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 -