title: Depression and infertility in women seeking bariatric surgery.
abstract: BACKGROUND
  Obesity has been associated with abnormalities in reproductive functioning and fertility in women. A number of potential mechanisms have been identified, including neuroendocrine functioning and polycystic ovarian syndrome. Associations between infertility, depression, and anxiety have been found in nonobese populations; however, the relationship between depression and infertility in women pursuing bariatric surgery has not been examined. This study sought to explore potential psychosocial correlates of infertility in a female bariatric population.
  
  
  METHODS
  Data were analyzed from female patients of childbearing age (n = 88; 70.5% Caucasian; mean age 36.2; mean education 14.3 years; mean body mass index [BMI] 47.9 kg/m(2)) psychologically evaluated for bariatric surgery. Participants were dichotomized as Infertility+(n = 43) or Infertility-(n = 45) based on a medical history self-report questionnaire. Medical records were reviewed for demographic characteristics, BMI, physical and/or sexual abuse history, psychiatric medication usage, outpatient behavioral health treatment, and psychiatric diagnoses.
  
  
  RESULTS
  Women identified as Infertility+were more likely to have been diagnosed with a depressive disorder not otherwise specified or a major depressive disorder (χ(2) = 3.71, P<.05, χ(2) = 4.33, P< .05) than Infertility-women. However, Infertility+women were less likely to be involved in outpatient behavioral health treatment (χ(2) = 5.65, P< .05) or to have a history of psychotropic medication usage (χ(2) = 4.61, P<.05).
  
  
  CONCLUSIONS
  Women struggling with infertility may be more psychiatrically vulnerable than other bariatric surgery candidates and less likely to have received mental health treatment. Additional research on the association between fertility, depression, behavioral health treatment, and obesity is warranted. Future research should consider whether this potential relationship changes after bariatric surgery.
authors: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Electronic address: merrelj@ccf.org.
authors: Julie
authors: J
authors: Merrell
authors: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors: Megan
authors: M
authors: Lavery
authors: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
authors: Kathleen
authors: K
authors: Ashton
authors: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
authors: Leslie
authors: L
authors: Heinberg
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D050110:Bariatric Surgery; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000523:psychology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Bariatric surgery; Behavioral health treatment; Depression; Infertility