Obesity and Clomiphene Challenge Test as Predictors of Outcome of in vitro Fertilization and Intracytoplasmic Sperm Injection

Swieten, Esther C.A.M. van; Leeuw-Harmsen, Loes van der; Badings, Erik A; Linden, Paul J.Q. van der

doi:10.1159/000084347

Cited by 88 publications

(74 citation statements)

References 34 publications

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“…Some authors have reported outcomes per cycle (Wittemer et al, 2000;Nichols et al, 2003;Dechaud et al, 2006), while others have chosen to report outcomes per woman (Wang et al, 2000;Krizanovska et al, 2002;Fedorcsak et al, 2004;van Swieten et al, 2005;Dokras et al, 2006). Except for three (Wang et al, 2000;Krizanovska et al, 2002;Nichols et al, 2003), all studies reporting outcomes per woman have only included one cycle per woman.…”

Section: Methodological Quality Of Included Studiesmentioning

confidence: 99%

“…Krizanovska et al (2002) and van Swieten et al (2005) reported all cases with positive b-hCG as clinical pregnancy, while Wittemer et al (2000) have used 'initiated pregnancies' without a clear definition of this term. Wang et al (2000) measured the probability of achieving at least one clinical pregnancy per woman whereas Nichols et al (2003) defined clinical pregnancy as the presence of a gestational sac at 6 -7 weeks gestation, identified via transvaginal scan.…”

Section: Pregnancy Ratementioning

confidence: 99%

See 1 more Smart Citation

Effect of overweight and obesity on assisted reproductive technology—a systematic review

Maheshwari

Stofberg

Bhattacharya

2007

Human Reproduction Update

434

286

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Obesity is known to be associated with sub-optimal reproductive performance but its direct effect on the outcome of assisted reproduction techniques (ART) is less clear. This present study aimed to perform a systematic review of the available evidence to assess the effects of obesity on the outcome of ART. A number of observational studies were identified. Interpretation of the results was compromised by variations in the methods used to define overweight and obese populations and inconsistencies in the choice and definition of outcome measures. Compared with women with a BMI of 25 kg/m 2 or less, women with a BMI 25 kg/m 2 have a lower chance of pregnancy following IVF [odds ratio (OR) 0.71, 95% CI: 0.62, 0.81], require higher dose of gonadotrophins (weighed mean differences 210.08, 95% CI: 149.12, 271.05) and have an increased miscarriage rate (OR 1.33, 95% CI: 1.06, 1.68). There is insufficient evidence on the effect of BMI on live birth, cycle cancellation, oocyte recovery and ovarian hyperstimulation syndrome. Further studies with clear entry criteria and uniform reporting of outcomes are needed to investigate the true impact of weight on the outcome of ART.

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Section: Methodological Quality Of Included Studiesmentioning

confidence: 99%

Section: Pregnancy Ratementioning

confidence: 99%

Effect of overweight and obesity on assisted reproductive technology—a systematic review

Maheshwari

Stofberg

Bhattacharya

2007

Human Reproduction Update

434

286

View full text Add to dashboard Cite

show abstract

“…In a prospective evaluation of the effect of obesity in IVF/ICSI in 162 patients, it was observed that obese women had a 45% lower fertilisation rate when compared with normal-weight controls (van Swieten et al 2005). A prospective cohort study of 50 overweight (BMI O26 kg/m 2 ) and 50 normal controls (BMI 18-25 kg/m 2 ) observed that fertilisation rate was significantly reduced in overweight women (46.2 vs 61.3%, P!0.05; Salha et al 2001).…”

Section: Obesity and The Oocytementioning

confidence: 99%

“…Obesity has been reported to affect ovarian stimulation in women undergoing treatment. Reported effects include prolonged ovarian stimulation, increased dose requirement of gonadotrophin, increased incidence of follicular asynchrony and increased cancellation rates (Mulders et al 2003, van Swieten et al 2005, Balen et al 2006, Bellver et al 2006, Maheshwari et al 2007, Esinler et al 2008. In a cohort study of women with PCOS undergoing ovulation induction with either clomiphene or gonadotrophins, it was observed that elevated BMI negatively affected ovulation rates.…”

Section: Obesity and Assisted Conceptionmentioning

confidence: 99%

The adverse effects of obesity on conception and implantation

Brewer¹,

Balen²

2010

Reproduction

418

277

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Whilst many multiparous women are obese (body mass index O30 kg/m 2 ), obesity has been associated with impaired fecundity; however, the mechanism which links obesity to reduced fertility remains to be fully elucidated. Obese women, particularly those with central obesity, are less likely to conceive per cycle. Obese women suffer perturbations to the hypothalamic-pituitary-ovarian axis, menstrual cycle disturbance and are up to three times more likely to suffer oligo-/anovulation. A fine hormonal balance regulates follicular development and oocyte maturation, and it has been observed that obesity can alter the hormonal milieu. Leptin, a hormone produced by adipocytes, is elevated in obese women, and raised leptin has been associated with impaired fecundity. Obesity impairs ovulation but has also been observed to detrimentally affect endometrial development and implantation. The expression of polycystic ovary syndrome (PCOS) is regulated, in part, by weight, and so obese women with PCOS often have a more severe phenotype and experience more subfertility. Obesity also impairs the response of women to assisted conception treatments. Weight loss through lifestyle modification or bariatric surgery has been demonstrated to restore menstrual cyclicity and ovulation and improve the likelihood of conception. In this article, we will discuss the effect of obesity upon key reproductive mechanisms and its relation to fertility treatments.

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“…While some studies on IVF reported less oocytes being collected from women with higher BMI [7,8,[15][16][17][18] Perhaps the response to exogenous gonadotropins administered during a stimulated cycle varies by patients' BMI and this can affect the oocyte yield. In our study the number of oocytes collected in an unstimulated IVM cycle was not affected by the patient`s BMI.…”

Section: Discussionmentioning

confidence: 99%

Effect of Body Mass Index on In Vitro Maturation Treatment Outcomes in Women without Polycystic Ovarian Syndrome

Ata¹

2013

J Fertil In Vitro IVF Worldw Reprod Med Genet Stem Cell Biol

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Purpose: Previous studies have suggested that obesity can affect the oocyte yield, embryo quality and pregnancy rates following IVF. In vitro maturation differs from IVF in several ways including lack of controlled ovarian stimulation, oocyte retrieval when majority are expected to be still immature, and possibly different endometrial environment due to short secretory phase and the lack of exposure to supraphysiologic estrogen levels. Therefore female obesity can affect IVM and IVF cycles differentially. This study aims to assess the effect of female obesity on IVM outcomes in women without polycystic ovarian syndrome. Methods:Retrospective chart review of 125 women who underwent an IVM cycle during a 5 year period. Women were divided to four categories based on Body Mass Index (BMI) according to the World Health Organization classification. Procedural and clinical outcomes were compared across different BMI categories. Independent effect of BMI on the odds of achieving a live birth was assessed using a multivariate logistic regression model. Results:The numbers of cumulus corona complexes, in vivo matured and immature oocytes collected, metaphase two oocytes available for fertilization, good quality embryos available for transfer and embryos transferred were not statistically significantly different across BMI categories. Likewise, in vitro maturation rate of immature oocytes, fertilization rate, embryo implantation, clinical pregnancy and live birth rates were similar across the groups. BMI category did not have an independent effect after adjusting for possible confounders in the regression model. Conclusions:BMI does not seem to affect IVM outcomes.

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Obesity and Clomiphene Challenge Test as Predictors of Outcome of in vitro Fertilization and Intracytoplasmic Sperm Injection

Cited by 88 publications

References 34 publications

Effect of overweight and obesity on assisted reproductive technology—a systematic review

Effect of overweight and obesity on assisted reproductive technology—a systematic review

The adverse effects of obesity on conception and implantation

Effect of Body Mass Index on In Vitro Maturation Treatment Outcomes in Women without Polycystic Ovarian Syndrome

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