PCOS in lesbian and heterosexual women treated with artificial donor insemination

Sutter, Petra De; Dutré, Tineke; Meerschaut, Frauke Vanden; Stuyver, Isabelle; Maele, Georges Van; Dhont, Marc

doi:10.1016/s1472-6483(10)60224-6

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…There are several other studies which also could not find a difference in PCOS prevalence based on sexual orientation (De Sutter et al , 2008; Smith et al , 2011). …”

Section: Discussionmentioning

confidence: 87%

“…Several investigations have identified gaps in the medical professions knowledge regarding this population (Denenberg, 1995; Abdessamad et al , 2013). Few studies have examined the medical conditions of women receiving sperm donation and only a handful compare heterosexuals and lesbians (Ferrara et al , 2000; De Sutter et al , 2008; Linara et al , 2011). …”

Section: Introductionmentioning

confidence: 99%

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Sexual orientation of women does not affect outcome of fertility treatment with donated sperm

et al. 2014

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STUDY QUESTIONIs there a difference in fertility between heterosexual women and lesbians undergoing sperm donation?SUMMARY ANSWERWomen undergoing treatment with donated sperm are equally fertile regardless of sexual orientation.WHAT IS KNOWN ALREADYLesbians have an increased prevalence of smoking, obesity, sexually transmitted diseases and, possibly, polycystic ovary syndrome, all factors known to affect fertility. Previous studies on sperm donation inseminations (D-IUI) show conflicting results regarding pregnancy outcome.STUDY DESIGN, SIZE, DURATIONThis is a national study of 171 lesbians and 124 heterosexual women undergoing sperm donation both as D-IUI (lesbian n = 438, heterosexual n = 298) and as embryo transfers (ET) after IVF with donated sperm (lesbians n = 225, heterosexuals n = 230) during 2005–2010.PARTICIPANTS/MATERIALS, SETTING, METHODSAll clinics in Sweden offering sperm donation recruited patients. Differences in patients' medical history, treatment results and number of treatments to live birth were analyzed using independent samples t-test, Pearson's χ2 test or Fisher's exact probability test.MAIN RESULTS AND THE ROLE OF CHANCE71.8% of heterosexuals and 69.0% of lesbians had a child after treatment. The mean number of treatments was 4.2 for heterosexual women and 3.9 for lesbians. The total live birth rate, regardless of treatment type, was 19.7% for heterosexuals and 19.5% for lesbians. For D-IUI, the live birth rate was 12.8% for heterosexuals and 16.0% for lesbians and the live birth rate for all IVF embryo transfers (fresh and thawed cycles) was 28.7% for heterosexuals and 26.2% for lesbians. There were no differences in live birth rate between the groups for each of the different types of insemination stimulations (natural cycle; clomiphene citrate; FSH; clomiphene citrate and FSH combined). Nor was there a difference in live birth rate between the groups for either fresh or thawed embryo transfer. There was no difference between the proportions of women in either group or the number of treatments needed to achieve a live birth. Heterosexuals had a higher prevalence of smokers (9.2%), uterine polyps (7.2%) or previous children (11.3%) than lesbians (smokers 2.8%, P = 0.03; polyps 1.8%, P = 0.03; child 2.5%, P = 0.003).LIMITATIONS, REASONS FOR CAUTIONThis study is limited to women living in stable relationships undergoing treatment with donated sperm in a clinical setting and may not apply to single women or those undergoing home inseminations.WIDER IMPLICATIONS OF THE FINDINGSThese results may influence healthcare policy decisions as well as increase the quality of clinical care and medical knowledge of healthcare professionals. The data also have important implications for individuals regarding screening, infertility diagnostic procedures and treatment types offered to heterosexuals and lesbians seeking pregnancy through sperm donation.STUDY FUNDING/COMPETING INTEREST(S)Funding was granted by the Stiftelsen Familjeplaneringsfonden i Uppsala; the Swedish Research Council for Health, Working...

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“…There are several other studies which also could not find a difference in PCOS prevalence based on sexual orientation (De Sutter et al , 2008; Smith et al , 2011). …”

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Sexual orientation of women does not affect outcome of fertility treatment with donated sperm

et al. 2014

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“…There was no significant difference in rates of endometriosis and fibroids 12, 31, 37. Two studies reported rates of confounders (alcohol, smoking and BMI) by sexual orientation,11, 31 and only one study took a confounder into account (no difference in BMI between groups when measuring PCOS) 30…”

Section: Resultsmentioning

confidence: 94%

“…12 However, there was no significantly higher rate amongst lesbians in three other studies. [30][31][32] There was significantly less chronic pelvic pain for lesbians in one study, 33 but no difference in another. 34 There was significantly more chronic pelvic pain for bisexual women in two studies.…”

Section: Study Characteristicsmentioning

confidence: 89%

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

Robinson

Galloway

Bewley

et al. 2016

BJOG

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BackgroundLittle is known about the gynaecological health of lesbian and bisexual (LB) women.ObjectivesTo examine differences in incidence and/or prevalence of gynaecological conditions in LB compared with heterosexual women.Search strategyThe systematic review protocol was prospectively registered (PROSPERO‐CRD42015027091) and searches conducted in seven databases.Selection criteriaComparative studies published 2000–2015, reporting any benign (non‐infectious) and/or malignant gynaecological conditions with no language or setting restrictions.Data collection and analysisInclusions, data extraction and quality assessment were conducted in duplicate. Meta‐analyses of condition prevalence rates were conducted where ≥3 studies reported results.Main resultsFrom 567 records, 47 full papers were examined and 11 studies of mixed designs included. No studies directly addressing the question were found. Two chronic pelvic pain studies reported higher rates in bisexual compared with heterosexual women (38.5 versus 28.2% and 18.6 versus 6.4%). Meta‐analyses showed no statistically significant differences in polycystic ovarian syndrome, endometriosis and fibroids. There was a higher rate of cervical cancer in bisexual than heterosexual women [odds ratio (OR) = 1.94; 95% CI 1.46–2.59] but no difference overall (OR = 0.76; 95% CI 0.15–3.92). There was a lower rate of uterine cancer in lesbian than heterosexual women (OR = 0.28; 95% CI 0.11–0.73) and overall (OR = 0.36; 95% CI 0.13–0.97), but no difference in bisexual women (OR = 0.43; 95% CI 0.06–3.07).ConclusionsMore bisexual women may experience chronic pelvic pain and cervical cancer than heterosexual women. There is no information on potential confounders. Better evidence is required, preferably monitoring sexual orientation in research using the existing validated measure and fully reporting results.Tweetable abstractLesbians have less uterine cancer than heterosexual women; bisexuals have more pelvic pain and cervical cancer.

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“…Because of the higher levels of testosterone, some have speculated that the incidence may be higher among lesbians, based on unsubstantiated ideas that female samesex desire is driven by "male hormones." One study reported that lesbians had higher rates of PCOS than heterosexual women (Agrawal et al, 2004), although two other studies failed to find this disparity (DeSutter et al, 2008;Smith et al, 2011). Obviously, three studies are not sufficient to answer the question about PCOS prevalence, nor whether it might be a reason for higher weights among SMW.…”

Section: Polycystic Ovary Syndrome (Pcos)mentioning

confidence: 99%

An Ecological Framework for Sexual Minority Women’s Health: Factors Associated With Greater Body Mass

Eliason

Fogel

2015

Journal of Homosexuality

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In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

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PCOS in lesbian and heterosexual women treated with artificial donor insemination

Cited by 22 publications

References 21 publications

Sexual orientation of women does not affect outcome of fertility treatment with donated sperm

Sexual orientation of women does not affect outcome of fertility treatment with donated sperm

Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis

An Ecological Framework for Sexual Minority Women’s Health: Factors Associated With Greater Body Mass

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