Obesity surgery · 2026
Menstrual and Reproductive Function Before and After Metabolic Bariatric Surgery.
СтатьяНазвание и аннотация: Перевод в очереди
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Whyte Martin, Attersley-Smith Stephanie, Hart Kathryn, Stone Sophia, Pring Christopher, Shawe Jill
Аннотация
AIMS: To evaluate the impact of metabolic bariatric surgery on menstrual function, hormonal profiles, and reproductive health in women of reproductive age.
MATERIALS AND METHODS: In this prospective cohort study, women aged 18-45 years undergoing Roux-en-Y gastric bypass or sleeve gastrectomy were recruited from a UK bariatric centre and followed for up to 24 months. Control participants were women with obesity receiving non-surgical weight management. Participants consented to clinical, biochemical, ultrasonographic, and questionnaire-based assessments of menstruation and pregnancy intentions.
RESULTS: Eighty-four women underwent surgery (49 bypass, 35 sleeve); 18 controls without surgery. By 24 months, 15 were lost to follow-up; mean excess weight loss was 64-73% with no difference between procedures. Anti-Mullerian Hormone (AMH) (n = 33) decreased post-surgery (16.6 to 16.0 pmol/L; P < 0.001); sex hormone-binding globulin (SHBG) increased (30.6 to 66.8 nmol/L; P < 0.001), and free androgen index (FAI) decreased (3.92 to 1.84; P < 0.001). Irregular menstruation and hirsutism decreased. Among 66 women with baseline transvaginal ultrasound scans, 33% had polycystic ovarian morphology, reducing to 10% postoperatively (n = 17); ovarian volume decreased significantly. At baseline (n = 76), 31% of surgical participants expressed a desire for pregnancy. Twenty pregnancies occurred, most 12-24 months post-surgery.
CONCLUSIONS: Metabolic bariatric surgery was associated with > 30 kg weight loss by 24 months, reduced FAI, and improvements in menstrual regularity, and ovarian morphology, suggesting potential improvement in fertility-related parameters. Given high pregnancy intention, findings support the need for integrated reproductive counselling and preconception care within bariatric pathways.
MATERIALS AND METHODS: In this prospective cohort study, women aged 18-45 years undergoing Roux-en-Y gastric bypass or sleeve gastrectomy were recruited from a UK bariatric centre and followed for up to 24 months. Control participants were women with obesity receiving non-surgical weight management. Participants consented to clinical, biochemical, ultrasonographic, and questionnaire-based assessments of menstruation and pregnancy intentions.
RESULTS: Eighty-four women underwent surgery (49 bypass, 35 sleeve); 18 controls without surgery. By 24 months, 15 were lost to follow-up; mean excess weight loss was 64-73% with no difference between procedures. Anti-Mullerian Hormone (AMH) (n = 33) decreased post-surgery (16.6 to 16.0 pmol/L; P < 0.001); sex hormone-binding globulin (SHBG) increased (30.6 to 66.8 nmol/L; P < 0.001), and free androgen index (FAI) decreased (3.92 to 1.84; P < 0.001). Irregular menstruation and hirsutism decreased. Among 66 women with baseline transvaginal ultrasound scans, 33% had polycystic ovarian morphology, reducing to 10% postoperatively (n = 17); ovarian volume decreased significantly. At baseline (n = 76), 31% of surgical participants expressed a desire for pregnancy. Twenty pregnancies occurred, most 12-24 months post-surgery.
CONCLUSIONS: Metabolic bariatric surgery was associated with > 30 kg weight loss by 24 months, reduced FAI, and improvements in menstrual regularity, and ovarian morphology, suggesting potential improvement in fertility-related parameters. Given high pregnancy intention, findings support the need for integrated reproductive counselling and preconception care within bariatric pathways.