Body Mass Index Impacts In Vitro Fertilization Stimulation

Hill, Micah J.; Hong, Steve; Frattarelli, John L.

doi:10.5402/2011/929251

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Many studies have reported a negative effect of obesity on fertility (Table 1). Obese women show a reduced response to gonadotrophin stimulation, resulting in lower estradiol levels and fewer collected follicles, with equal or reduced live birth rates being reported post transfer (Esinler et al 2008;Hill et al 2011;Marquard et al 2011). Follicular fluid bathing the cumulus-oocyte complex in obese women contains markedly increased levels of triglycerides and free fatty acids, potentially contributing to reduced oocyte quality (Robker et al 2009).…”

Section: Obesity and Periconceptional High-fat Dietsmentioning

confidence: 99%

Parental diet, pregnancy outcomes and offspring health: metabolic determinants in developing oocytes and embryos

Sinclair

Watkins

2014

Reprod. Fertil. Dev.

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The periconceptional period, embracing the terminal stages of oocyte growth and post-fertilisation development up to implantation, is sensitive to parental nutrition. Deficiencies or excesses in a range of macro- and micronutrients during this period can lead to impairments in fertility, fetal development and long-term offspring health. Obesity and genotype-related differences in regional adiposity are associated with impaired liver function and insulin resistance, and contribute to fatty acid-mediated impairments in sperm viability and oocyte and embryo quality, all of which are associated with endoplasmic reticulum stress and compromised fertility. Disturbances to maternal protein metabolism can elevate ammonium concentrations in reproductive tissues and disturb embryo and fetal development. Associated with this are disturbances to one-carbon metabolism, which can lead to epigenetic modifications to DNA and associated proteins in offspring that are both insulin resistant and hypertensive. Many enzymes involved in epigenetic gene regulation use metabolic cosubstrates (e.g. acetyl CoA and S-adenosyl methionine) to modify DNA and associated proteins, and so act as 'metabolic sensors' providing a link between parental nutritional status and gene regulation. Separate to their genomic contribution, spermatozoa can also influence embryo development via direct interactions with the egg and by seminal plasma components that act on oviductal and uterine tissues.

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Section: Obesity and Periconceptional High-fat Dietsmentioning

confidence: 99%

Parental diet, pregnancy outcomes and offspring health: metabolic determinants in developing oocytes and embryos

Sinclair

Watkins

2014

Reprod. Fertil. Dev.

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“…In the final analysis, 105 eligible studies (19 prospective and 86 retrospective cohort studies) were included, involving more than 271,632 pregnant women (Figure 1). 14,15,28–130 The main characteristics of included studies were summarized in Table S1. In total, 100 studies reported the association between maternal BMI and CPR among pregnant women undergoing ART, among which 53 reported MR and 51 reported LBR (Table S1).…”

Section: Resultsmentioning

confidence: 99%

“…In total, 100 studies reported the association between maternal prepregnancy body weight and CPR after ART 14,15,28–55,58–80,82–117,119–122,124–130 . At per‐woman level, 54 studies, involving 109,688 pregnant women, showed an inverted J‐shaped relationship between maternal BMI and CPR ( P n < 0.01) 14,28–31,34–36,40,41,44,46,47,49,53,58,60,61,64–68,75,76,78,82,85,86,88–95,97,99,103–106,109,112–114,119,121,124,126–128,130 . Compared with the reference BMI value (21.75 kg/m 2 ), BMI > 22.5 kg/m 2 was associated with lower CPR (Figure 2a and Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Association between maternal prepregnancy body mass index and pregnancy outcomes following assisted reproductive technology: A systematic review and dose–response meta‐analysis

et al. 2021

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Summary This systematic review investigated dose–response relationship between maternal prepregnancy body mass index (BMI) and pregnancy outcomes following assisted reproductive technology, including clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR). We searched four major databases and finally included 105 studies involving more than 271,632 pregnant women. We performed linear or nonlinear dose–response meta‐analyses using random effects models. At per‐woman level, pooling of unadjusted estimates shown an inverted J‐shaped relationship between maternal BMI and CPR; pooling of adjusted estimates showed a linear association, suggesting statistical association between higher maternal BMI and lower CPR (adjusted OR [aOR] for 5‐unit increase in BMI: 0.96, 95%CI: 0.94–0.98). At per‐cycle level, linear dose–response relationship was found between maternal BMI and CPR (crude relative risk, RR, [cRR] for 5‐unit increase in BMI 0.97, 0.96–0.98; aOR 0.96, 0.94–0.99). Linear dose–response relationship was established between maternal BMI and the outcomes of MR or LBR (higher BMI associated with higher MR [cRR 1.15, 1.08–1.22] and lower LBR [cRR 0.91, 0.88–0.94] at per‐woman level). Sensitivity analyses showed no significant changes. In conclusion, there is dose–response relationship between maternal BMI and pregnancy outcomes following assisted reproductive technology. Higher BMI values may suggest suboptimal pregnancy outcomes.

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“…В некоторых странах страховые компании не оплачивают протоколы ЭКО женщинам с ожирением [40]. Ряд авторов отмечает, что у женщин с ожирением в процессе стимуляции увеличивается доза гонадотропинов и число дней, необходимых для эффективной стимуляции [41][42][43]. Причем у женщин с ИМТ более 30 кг/м 2 доза гонадотропинов превышает дозу у женщин с нормальным весом и сниженным овариальным резервом.…”

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