Document Detail


Effects of gastric bypass surgery on female reproductive function.
MedLine Citation:
PMID:  23066115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Reproductive function may improve after bariatric surgery, although the mechanisms and time-related changes are unclear.
OBJECTIVE: The objective of the study was to determine whether ovulation frequency/quality as well as associated reproductive parameters improve after Roux en Y gastric bypass surgery.
DESIGN: This was a prospective cohort study that enrolled female subjects from 2005 to 2008 with study visits at baseline and then 1, 3, 6, 12, and up to 24 months after surgery.
SETTING: The study was conducted at an academic health center.
PATIENTS: Twenty-nine obese, reproductive-aged women not using confounding medications participated in the study.
MAIN OUTCOME MEASURES: The primary outcome was integrated levels of urinary progestin (pregnanediol 3-glururonide) from daily urinary collections at 12 months postoperatively. Secondary outcomes were changes in vaginal bleeding, other biometric, hormonal, ultrasound, dual-energy x-ray absorptiometry measures, and Female Sexual Function Index.
RESULTS: Ninety percent of patients with morbid obesity had ovulatory cycles at baseline, and the ovulatory frequency and luteal phase quality (based on integrated pregnanediol 3-glururonide levels) were not modified by bariatric surgery. The follicular phase was shorter postoperatively [6.5 d shorter at 3 months and 7.9-8.9 d shorter at 6-24 months (P < 0.01)]. Biochemical hyperandrogenism improved, largely due to an immediate postoperative increase in serum SHBG levels (P < 0.01), with no change in clinical hyperandrogenism (sebum production, acne, hirsutism). Bone density was preserved, contrasting with a significant loss of lean muscle mass and fat (P < 0.001), reflecting preferential abdominal fat loss (P < 0.001). Female sexual function improved 28% (P = 0.02) by 12 months.
CONCLUSIONS: Ovulation persists despite morbid obesity and the changes from bypass surgery. Reproductive function after surgery is characterized by a shortened follicular phase and improved female sexual function.
Authors:
Richard S Legro; William C Dodson; Carol L Gnatuk; Stephanie J Estes; Allen R Kunselman; Juliana W Meadows; James S Kesner; Edward F Krieg; Ann M Rogers; Randy S Haluck; Robert N Cooney
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-12
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  97     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-12     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4540-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adult
Body Mass Index
Bone Density / physiology
Cohort Studies
Female
Gastric Bypass* / rehabilitation
Humans
Infertility, Female / etiology,  physiopathology,  surgery
Menstrual Cycle / physiology
Menstruation Disturbances / epidemiology
Obesity, Morbid / complications,  physiopathology,  surgery*
Parity / physiology
Pregnancy
Reproduction / physiology*
Weight Loss / physiology
Young Adult
Grant Support
ID/Acronym/Agency:
C06 RR016499/RR/NCRR NIH HHS; C06 RR016499/RR/NCRR NIH HHS; UL1 RR033184/RR/NCRR NIH HHS; UL1RR033184/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
J Clin Endocrinol Metab. 2012 Dec;97(12):4352-4   [PMID:  23223480 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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