The adverse effect of overweight in assisted reproduction treatment outcomes

Abstract

ObjectiveTo assess Body Mass Index (BMI) effects on the results obtained from ICSI cycles.MethodsWe studied 266 ICSI cycles performed between January 2014 and December 2016. The patients were grouped according to their BMI in: Normal (18.5-24.9), Overweight (25.0-29.9) and Obese (>30). We compared the following variables between the groups: number of antral follicles, ovarian stimulation length, gonadotropin dose used, maximum estradiol level, follicles developed/antral follicles, retrieved oocytes/developed follicles and mature/retrieved oocytes, normal fertilization rate, embryo achieved/normal fertilized oocytes, clinical pregnancy and implantation rates. We used the Kruskal-Wallis and the Chi square tests. p<0.05 was considered significant.ResultsNormal, Overweight and Obese patients presented comparable values for number of antral follicles (11.6±5.4, 12.5±5.5, 12.2±5.7), ovarian stimulation length (7.5±1.4, 7.6±1.1, 7.8±1.3) and gonadotropin dose used (2043±489, 1940±536, 2109±605). Obese patients had lower values of estradiol (1560±610, 1511±635, 1190±466; p=0.018), developed follicles (81%, 76%, 70%; p<0.0001), and retrieved oocytes (91%, 90%, 84%; p=0.0017); and not significantly lower values of mature oocytes (82%, 82%, 77%; p=0.26). The groups had comparable fertilization rates (72%, 73%, 69%) and embryo achieved rates (67%, 63%, 72%). The normal group had higher, but not significantly higher pregnancy and implantation rates (43%, 40%, 38%, p=0.53; and 33%, 26%, 23%; p=0.11), and significantly higher ongoing pregnancy rates (37%, 33%, 33%, p=0.042).ConclusionIncreased BMI patients had impaired ovarian response and lower pregnancy rates in ICSI cycles.

Defining Low Prognosis Patients Undergoing Assisted Reproductive Technology: POSEIDON Criteria—The Why

“…This phenomenon is most often found in women of advanced maternal age, mainly because of reduced ovarian reserve caused by accelerated follicular loss ( 18 ). In some cases, however, a low ovarian response might be seen in good ovarian reserve patients caused by a suboptimal gonadotropin dosage used for OS, for example in obese women ( 19 ), or due to the presence of genetic polymorphisms affecting endogenous gonadotrophins or their receptors ( 20 – 22 ). Both conditions ultimately alter the response of recruitable follicles to exogenous gonadotrophins ( 23 – 25 ).…”

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

“…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).…”

Roles of kisspeptin in IVF/ICSI-treated infertile women and in human granulosa cells

“…Non-obese subjects (BMI < 25 kg/m 2 according to the BMI classification for Asian population) were recruited because we would like to avoid the confounding effects of obesity on IVF treatment as a previous publication revealed that obesity could have negative impacts on oocyte maturation, ovulation, endometrial development, and implantation. 33 The exclusion criteria were history of endocrine diseases (i.e. hypo/hyperthyroidism, Cushing’s syndrome, diabetes, and congenital adrenal hyperplasia), hormonal contraceptive use within two months (i.e.…”