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 ¼ 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 Infertilityþ (n ¼ 43) or Infertility� (n ¼ 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 Infertilityþ were more likely to have been diagnosed with a depressive disorder not otherwise specified or a major depressive disorder (χ 2 ¼ 3.71, P o .05,
Prior to 1989, microsurgical reconstructive procedures in Vietnam were rare. Under the auspices of Operation Smile, such techniques were introduced in the Military Hospital #108 in Hanoi, and subsequently to the Center for Traumatology in Ho Chi Minh City and the Plastic Surgery Center in Hanoi. Over a 14-year period, 10 missions to Vietnam performed approximately 250 plastic surgical cases, including more than 125 free tissue transfers. There were no flap failures. As a result of these missions, Vietnamese surgeons now independently perform microsurgical procedures with a high level of proficiency. Operation Smile missions have emphasized education in specialized areas such as facial reanimation, free fibula transfer, one-stage penile reconstruction, and perforator flaps. Repeat missions have allowed for patient follow-up, as well as additional educational exchange. Several Vietnamese surgeons have traveled abroad to obtain additional training and have set up training sessions for other areas in Vietnam. Charitable organizations can facilitate the introduction of complex medical procedures such as microsurgery to developing countries.
