Introduction Female patients expect improved quality of life, including sexual health and regain of fertility after bariatric surgery. Little has been published on to the extent to which patients’ expectations are met by the weight loss after surgery. Aim To explore how women perceive the effects of bariatric surgery on quality of life, focusing on sexual health and fertility. Methods A qualitative study based on thematic analysis, supported by questionnaire data. Interviews following a semistructured guide were conducted with childless women (n = 11) aged 25–34 years recruited from a university-affiliated Swedish bariatric center. The interviews took place 18 months after surgery in the participants’ homes or at the hospital and were recorded and transcribed verbatim. Data were analyzed with a thematic approach. Questionnaires were filled in at the time of the interviews and compared with preoperative data using a Wilcoxon test for paired data. Main outcome measures Participants described experiences related to female sexual health after bariatric surgery. The Hospital Anxiety and Depression Scale and the Female Sexual Function Index questionnaires were administered preoperatively and postoperatively. Results “A new beginning” was identified as the master theme, with 3 underlying subthemes: “Being worthy of love,” “Exploring sexuality,” and “Considering parenthood.” The participants described a transformation into being more comfortable with themselves that affected all areas of life, including sexual life. These findings were supported by lower scores for depression, 6.5 vs 2, and improved total Female Sexual Function Index scores, median 23.3 preoperatively and 29.1 postoperatively, P = .012. Conclusions Improved body image and enhanced self-esteem play important roles in improved sexual functioning in women after bariatric surgery. Nilsson-Condori E, Järvholm S, Thurin-Kjellberg A, et al. A New Beginning: Young Women’s Experiences and Sexual Function 18 Months After Bariatric Surgery. Sex Med 2020;8:730–739.
Objective: To study childbirth and the risk of miscarriage and infertility among women who have received a diagnosis of type 2 diabetes before the start of their reproductive journey. Design: Register-based cohort study using the Sk ane Healthcare Register. Setting: All healthcare visits for the whole population of the southernmost region in Sweden over the past 20 years. Patient(s): All women who were aged 18-45 years between January 1, 1998 and December 31, 2019 and who received a clinical diagnosis of type 2 diabetes before their first childbirth, miscarriage, or infertility diagnosis (n ¼ 230) were compared with a healthcareseeking population of women without any type of diabetes, matched for calendar year and age (n ¼ 179,434). Intervention(s): None. Main Outcome Measure(s): Childbirth, miscarriage, and infertility diagnosis. Result(s): The birthrate was lower among women with type 2 diabetes (62.6% vs. 83.8%), and they were less likely to give birth (crude risk ratio [RR] ¼ 0.73, 95% confidence interval [CI]: 0.66-0.81). They had a higher risk of experiencing a miscarriage (RR ¼ 1.88, 95% CI: 1.50-2.36). The risk of infertility was increased (RR ¼ 3.44, 95% CI: 2.88-4.10) as was the risk of having infertility and not giving birth (RR ¼ 4.47, 95% CI: 3.44-5.82). All results remained the same after adjustment for polycystic ovary syndrome and obesity. Conclusion(s):Women with type 2 diabetes with onset before their reproductive journey were more often childless compared with women without diabetes and had a higher risk of experiencing both miscarriage and infertility. This patient group may be in need of targeted information regarding potential fertility issues as part of their clinical treatment. (Fertil Steril Ò 2021;116:505-13. Ó2021 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.
Background: In Sweden, 4700 women seek bariatric surgery annually, many of those being nulliparous. Anovulation is common among obese women, but bariatric surgery is not considered a treatment for infertility. The aim of this study was to explore the motives of women in fertile age for seeking bariatric surgery and their expectations on future fertility. Materials and methods: A qualitative study with semi-structured interviews with childless women ( n = 12) aged 20 to 35 years. Interviews were conducted 1 to 3 weeks prior to surgery, transcribed verbatim, and analyzed with thematic analysis. Results: “To get back on track” was identified as a master theme with 3 underlying subthemes, with the following headings: “A better me,” “A fertile me,” and “A pregnant me.” The participants were hoping that weight-loss would make them feel more content with themselves, break isolation, and make it easier to find a partner. The participants considered fertility to improve after bariatric surgery, mainly based on stories from other patients of bariatric surgery. Having a child was expressed to be of great importance to them. Conclusions: Even though obese young women do not seek bariatric surgery for fertility reasons alone, there is a general perception of enhanced fertility after surgery, which is regarded as positive and important.
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