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Control participants were women with obesity receiving non-surgical weight management.<\/jats:p>\n                    <jats:p>Participants consented to clinical, biochemical, ultrasonographic, and questionnaire-based assessments of menstruation and pregnancy intentions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u201373% with no difference between procedures. Anti-Mullerian Hormone (AMH) (n\u2009=\u200933) decreased post-surgery (16.6 to 16.0 pmol\/L; P\u2009&lt;\u20090.001); sex hormone-binding globulin (SHBG) increased (30.6 to 66.8 nmol\/L; P\u2009&lt;\u20090.001), and free androgen index (FAI) decreased (3.92 to 1.84; P\u2009&lt;\u20090.001). Irregular menstruation and hirsutism decreased. Among 66 women with baseline transvaginal ultrasound scans, 33% had polycystic ovarian morphology, reducing to 10% postoperatively (n\u2009=\u200917); ovarian volume decreased significantly. At baseline (n\u2009=\u200976), 31% of surgical participants expressed a desire for pregnancy. Twenty pregnancies occurred, most 12\u201324 months post-surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Metabolic bariatric surgery was associated with &gt;\u200930 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08852-6","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:34:50Z","timestamp":1785900890000},"page":"4535-4543","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Menstrual and Reproductive Function Before and After Metabolic Bariatric Surgery"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2897-2026","authenticated-orcid":false,"given":"Martin","family":"Whyte","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Attersley-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Hart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Pring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Shawe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"8852_CR1","unstructured":"Statistics on Obesity. 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