Superovulation with urinary human follicle-stimulating hormone: correlations with body mass index and body fat distribution

Abstract

Our objective was to investigate the relationship between body mass index (BMI), waist/hip ratio (WHR), follicle-stimulating hormone (FSH) dose, length of stimulation and clinical outcome in infertile women with and without polycystic ovary syndrome (PCOS) undergoing controlled ovarian hyperstimulation. Controlled ovarian hyperstimulation was induced in 60 women for a total of 111 cycles (48% in PCOS patients) with urinary human FSH (u-hFSH). A significant correlation between BMI, u-hFSH dose and duration of stimulation was found in PCOS and non-PCOS patients with WHR < 0.8. These correlations were not present in PCOS patients with WHR > 0.8. Pregnant patients received significantly less ampules of u-hFSH. From our data we suggest a controlled ovarian hyperstimulation protocol, for obese non-PCOS patients and obese PCOS patients with WHR < 0.8, starting with a double dose of u-FSH.

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“…This phenomenon has already been described (16,17) using clomiphene citrate treatment: with increasing body weight the dose of clomiphene citrate had to be increased progressively, and there was a positive correlation between clomiphene citrate dose and body weight. BMI also was found to be significantly correlated with both the number of FSH ampoules administered and the length of stimulation (8). In this study, the number of collected oocytes significantly decreased with an increase of BMI.…”

The influence of body mass index on in vitro fertilization outcome

“…requirement during COH [4,5,[14][15][16][17]; decreased serum estradiol concentrations [7,16]; and a lower number of retrieved oocytes [16,18]. Moreover, other studies have also reported that, in women younger than 35 years, a higher BMI was negatively associated with the number of retrieved mature oocytes as well as fertilization, implantation, pregnancy, clinical pregnancy, and live birth rates [18,19].…”

Extremes of body mass do not adversely affect the outcome of superovulation and in-vitro fertilization

“…Central adiposity (android fat distribution) has more impact on the reproductive sequelae associated with obesity (Norman and Clark, 1998). Zullo et al (1996) suggested that a doubling of gonadotrophin dose was necessary for adequate ovarian stimulation in non-PCOS obese patients with a waist:hip ratio of 0.8 or more. Furthermore, Wass et al (1997) reported that women with an android fat distribution, defined as a waist:hip ratio Ͼ0.8, had less than half the pregnancy rate of those with gynaecoid body shape in IVF-embryo transfer treatment.…”