Does obesity have detrimental effects on IVF treatment outcomes?

Abstract

BackgroundThe aim of this study was to investigate the influence of body mass index (BMI) on the in vitro fertilization (IVF) treatment outcomes in a cohort of women undergoing their first IVF, using an intracytoplasmic sperm injection (ICSI).MethodsThis retrospective cohort study included 298 cycles from women younger than 38 years old undergoing IVF-ICSI at a university infertility clinic. The treatment cycles were divided into three groups according to the BMI of the women involved: normal weight (18.5 ≤ BMI < 25 kg/m2, 164 cycles), overweight (25 ≤ BMI < 30 kg/m2, 70 cycles), and obese (BMI ≥ 30 kg/m2, 64 cycles). The underweight women (BMI < 18.5 kg/m2) were not included in the analysis due to small sample size (n = 22). The patient characteristics and IVF-ICSI treatment outcomes were compared between the BMI groups.ResultsThe total gonadotropin dose (p <0.001) and duration of stimulation (p = 0.008) were significantly higher in the obese group when compared to the normal BMI group. There were no significant differences across the BMI categories for the other IVF-ICSI cycle outcomes measured, including the number of retrieved oocytes, mature oocytes, embryos suitable for transfer, proportion of oocytes fertilized, and cycle cancellation rates (p >0.05 for each). Additionally, clinical pregnancy, spontaneous abortion, and the ongoing pregnancy rates per transfer were found to be comparable between the normal weight, overweight, and obese women (p >0.05 for each).ConclusionObese women might require a significantly higher dose of gonadotropins and longer stimulation durations, without greatly affecting the pregnancy outcomes.

Impact of Body Mass Index on Outcomes of In Vitro Fertilization/Intracytoplasmic Sperm Injection Among Polycystic Ovarian Syndrome Patients

“…In the setting of IVF, increased doses of gonadotropin for inducing ovulation or stimulating the ovaries to obtain mature oocytes were required in obese women [6,13]. Impaired ovarian responsiveness to gonadotropin stimulation and reduced number of oocytes retrieved were reported to be associated with obesity [14,15].…”

Obesity Index That Better Predict Ovarian Response: Body Mass Index, Waist Circumference, Waist Hip Ratio, or Waist Height Ratio in Women Undergoing ICSI : A Pilot Study

“…It has been reported that women with BMI more than 35 kg/m2 are at high risk during ART [17] . Therefore, many prior studies have investigated the impact of raised BMI on the pregnancy outcomes of IVF/ICSI but with disparate results [23] . Some studies conducted on the patients undergoing IVF/ICSI using DE reported the negative impact of BMI, whereas others reported no difference in the reproductive outcomes in obese and normal DE recipients [24][25][26] .…”

“…Many studies suggest that the pregnancy outcome followed by ART is not influenced by BMI. However, they might require a high dose of gonadotropin and a longer period of stimulation [23,31] .…”

Could Advanced Glycation End Products Explain the Poor Response to Controlled Ovarian Hyperstimulation in Obese Women?

“…Although infertility associated with obesity has been related to anovulation [7], data have shown that the time to spontaneous pregnancy is significantly longer in obese women even in those who have regular menstrual cycles [10][11]. Despite data pertaining to obesity and IVF success from individual centers is controversial [101][102][103], data from large national studies showed that, obese women undergoing COH with oocyte retrieval for IVF have significantly worse outcomes compared to normal-weight women [104][105].…”