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Contraception and Conception After Bariatric Surgery.

Marie N Menke1, Wendy C King, Gretchen E White

  • 1University of Pittsburgh School of Medicine, the University of Pittsburgh Graduate School of Public Health, and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Weill Cornell University Medical Center, New York, New York; the University of Washington, Seattle, Washington; the Neuropsychiatric Research Institute, Fargo, North Dakota; Brody School of Medicine, East Carolina University, Greenville, North Carolina; Oregon Health & Science University, Portland, Oregon; North Dakota State University, Fargo, North Dakota; and the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.

Obstetrics and Gynecology
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PubMed
Summary
This summary is machine-generated.

Contraceptive practices after bariatric surgery often do not align with the recommended 18-month delay for conception. Conception rates remain significant, particularly in the early post-surgical period, highlighting a need for improved guidance.

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Area of Science:

  • Bariatric Surgery Outcomes
  • Reproductive Health
  • Contraceptive Practices

Background:

  • Bariatric surgery significantly impacts physiological processes, including reproductive health.
  • Understanding contraceptive use and conception rates post-surgery is crucial for patient management.

Purpose of the Study:

  • To examine contraceptive practices and conception rates in women of reproductive age following bariatric surgery.
  • To assess early (less than 18 months) and overall conception rates post-bariatric surgery.

Main Methods:

  • A prospective, multicenter cohort study (Longitudinal Assessment of Bariatric Surgery-2) involving 710 women (18-44 years old).
  • Self-reported contraceptive practices and pregnancies were assessed annually for up to 7 years.
  • Analysis focused on contraceptive use, overall conception rate, and early conception.

Main Results:

  • In the first year post-surgery, 40.5% used only protected intercourse and 41.5% had unprotected intercourse without trying to conceive.
  • The conception rate was 42.3 per 1,000 woman-years within 18 months post-surgery.
  • Factors associated with early conception included younger age, being married, and prioritizing future pregnancy.

Conclusions:

  • Post-bariatric surgery contraceptive practices and conception rates do not consistently adhere to the recommended 18-month delay.
  • There is a need for enhanced patient counseling regarding contraception and pregnancy timing after bariatric procedures.