Conception rates and contraceptive use after bariatric surgery among women with infertility: Evidence from a prospective multicenter cohort study

Marie N. Menke, Wendy C. King, Gretchen E. White, Gabriella G. Gosman, Anita P. Courcoulas, Gregory F. Dakin, David R. Flum, Molly J. Orcutt, Alfons Pomp, Walter J. Pories, Jonathan Purnell, Kristine J. Steffen, Bruce Wolfe, Susan Z. Yanovski

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Abstract

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.

Original languageEnglish (US)
JournalSurgery for Obesity and Related Diseases
DOIs
Publication statusPublished - Jan 1 2019

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Keywords

  • Bariatric surgery
  • Conception
  • Contraception
  • Infertility

ASJC Scopus subject areas

  • Surgery

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