ASRM:Press Release

Reproductive Health Findings for Bariatric Patients: Obesity at Young Age Increases Likelihood of Infertility and Polycystic Ovary Syndrome; Chances of Pregnancy and Live Birth Are Good

In an observational study of the reproductive health of women undergoing bariatric surgery, researchers analyzed data from 1,538 patients treated at six US clinical sites participating in the Longitudinal Assessment of Bariatric Surgery (LABS) study, supported by the National Institutes of Health.

The participants were measured for height and weight and answered questions about their sexual history, pregnancy history, infertility history, history of polycystic ovary syndrome (PCOS), history of contraceptive use, and plans for future pregnancy. The participants also completed a validated self-administered weight history, giving their weights at 18, 25 and 30 years.

The researchers found that women who became obese by age 18 were more likely to have a history of infertility and polycystic ovary syndrome and less likely to become pregnant than women who became obese later in life. However, the overall percentages of LABS-2 participants who had at least one pregnancy (79%) and at least one live birth (74%) were comparable to the general US population.

While about half of the women surveyed between ages 18 and 44 and not reporting menopause, sterilization, partner sterilization, or other impediments to pregnancy said that they would never try to become pregnant after bariatric surgery, 30% of women in this category thought the possibility of future pregnancy was very important. Of those women, almost 33% planned to get pregnant within two years of having bariatric surgery.

“As the incidence of obesity increases in the United States, women’s health care practitioners are likely to care for a substantial number of patients who will undergo bariatric surgery. Studies like this one are extremely useful to help us determine how to advise these patients and best meet their needs,” remarked William Gibbons, MD, President-Elect of the American Society for Reproductive Medicine.

Gosman et al, Reproductive Health of Women Electing Bariatric Surgery, Fertility and Sterility, in press, www.fertstert.org

Couples at Risk for Passing Genetic Disorders to Offspring Prefer Preimplantation Genetic Diagnosis to Prenatal Diagnosis

Couples at high risk for transmitting a genetic disorder to their children are often unaware of their options for pre-conception or post-conception testing. Dutch researchers investigated the preferences of 210 couples of reproductive age regarding two types of genetic testing- preimplantation genetic diagnosis (PGD) and prenatal diagnosis (PND).

In order to do PGD, in vitro fertilization must be performed so that a single cell from each embryo may be tested for the genetic disorder. The doctors are then able to transfer only embryos negative for the disorder so that in a resulting pregnancy, the fetus will be free of the disease. PND takes place in the first trimester of pregnancy and a diagnosis of fetal abnormality presents the couple with the difficult decision of whether or not to terminate the pregnancy.

The participating couples were contacted through 15 patient organizations representing 38 genetic disorders and were of reproductive age (woman 18-40 years old) and wanted to have children.

One hundred and twenty-seven couples (60%) expressed a wish to have diagnostic testing- PND or PGD- performed. Prior to participating in the study, 90 couples (42%) had never heard of PGD.

Ninety-four (74%) couples preferred testing with PGD to PND. Most of the couples preferring PGD to PND did so because they objected to pregnancy termination. Most couples preferring PND did not want to go through IVF.

In a scenario involving a two year waiting list for PGD, 102 couples (80%) preferred PGD with no wait. However, with the imposition of a two-year waiting period only 58 couples (46%) would opt to wait to have PGD.

Elizabeth Ginsburg, MD, President of the Society for Assisted Reproductive Technology commented, “It is important that couples carrying genetic disorders receive information on all their treatment options before trying to conceive. It is also important to expand access to treatment in addition to awareness. Our situation in the United States differs significantly from that of the Netherlands. But many US patients face a conundrum similar to the waiting list- they would prefer PGD to PND, but lack insurance coverage for assisted reproductive technologies.”

Musters et al, Perspectives of couples with high risk of transmitting genetic disorders, Fertility and Sterility, in press, www.fertstert.org

The American Society for Reproductive Medicine is a multidisciplinary organization dedicated to the advancement of the art, science, and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers.

The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility and the Society of Reproductive Surgeons.

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