Effect of body mass index on intrauterine insemination cycle success

Whynott, Rachel M.; Summers, Karen M.; Voorhis, Bradley J. Van; Mejia, Rachel B.

doi:10.1016/j.fertnstert.2020.07.003

Cited by 18 publications

(18 citation statements)

References 38 publications

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“… 14 , 15 Some studies have shown that overweight and obese patients have a higher fecundity than normoweight women when undergoing controlled ovarian hyperstimulation with IUI, 16 while other studies have reported negative effects of female obesity on the success of IUI treatment. 17 , 18 The selection of the sample population for the these previous studies were primarily based on BMI, rather than being limited to women with PCOS. Therefore, the present study addressed the impact of BMI as well as other factors in patients with PCOS undergoing COS with IUI on the improvement of pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

Predictors of pregnancy after intrauterine insemination in women with polycystic ovary syndrome

et al. 2021

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Objective To evaluate the effects of body mass index (BMI) in patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI). Methods This retrospective study evaluated couples with PCOS undergoing COS and IUI. The relationship between cumulative IUI pregnancy outcomes and BMI, treatment cycles, treatment schemes, number of dominant follicles, endometrial thickness, infertility duration and type of infertility was analysed. Results The study evaluated 831 IUI cycles in 451 couples with PCOS. Compared with normoweight women, overweight and obese women required more human menopausal gonadotropin (hMG) doses and more days of COS. Gestational diabetes mellitus occurred more frequently in the obese group than in the other BMI groups. The clinical pregnancy and live birth rates in the hMG, clomiphene citrate (CC) + hMG and letrozole (LE) + hMG groups were significantly higher than those in the CC and LE groups. The clinical pregnancy rate was higher in the secondary infertility group compared with the primary infertility group. Conclusion Obese women might require more hMG doses and more days of COS to overcome the effects of weight. As BMI increases, the incidence of gestational diabetes might also increase. The number of cycles and type of infertility may have a predictive value for pregnancy outcomes.

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Section: Introductionmentioning

confidence: 99%

Predictors of pregnancy after intrauterine insemination in women with polycystic ovary syndrome

et al. 2021

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“…Studies have found that compared to women with normal BMI, the live birth rate of women with increased BMI is significantly decreased [19,20]. Some scholars believe that there is no significant correlation between high BMI and live birth rate [21,22]. This study showed that there were significant differences in live birth rates among the different BMI groups.…”

Section: Bmi and Reproductive Outcomes In Older Patients With Dormentioning

confidence: 52%

Obesity and adverse pregnancy outcomes in older patients with decreased ovarian reserve: a retrospective single-centre study

Lin

Shi

et al. 2021

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BackgroundIn recent years, infertility has increased in older women with decreased ovarian reserve (DOR). Studies have shown that women with DOR have fewer oocytes, which are poorer in quality, and have an increased risk of adverse pregnancy outcomes. Pre-pregnancy BMI is significantly correlated with many adverse pregnancy outcomes. Therefore, we conducted this study to explore the correlation between body mass index (BMI) and abortion and live birth in older patients with DOR. MethodsThe clinical data of 2052 older women with infertility and DOR admitted to the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from August 2009 to May 2018 were analysed retrospectively. Patients were divided into underweight (BMI < 18.5 kg/m 2 ; n = 56), normal weight (18.5 kg/m 2 ≤ BMI < 24 kg/m 2 ; n = 1389), overweight (24 kg/m 2 ≤ BMI < 28 kg/m 2 ; n = 527) and obese (BMI ≥ 28 kg/m 2 ; n = 80). We compared the pregnancy outcomes of patients in each group. ResultsLogistic regression analysis showed that being overweight or obese were independent risk factors for miscarriage (P < 0.05) and protection factors for live births (P<0.05). Being underweight was a protective factor for live births (P < 0.05). ConclusionsThe abortion and live birth rates in older infertile women with DOR are correlated with BMI. Higher BMI was associated with higher abortion rates and lower live birth rates. Being underweight also correlated with the live birth rate. Therefore, to improve pregnancy outcomes, we suggest that older patients with DOR may benefit from maintaining a normal weight before seeking fertility treatments.

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“…Due to the lack of patients with BMI>30 kg/m 2 in our cohort, we are unable to estimate the effect of obesity. However, other authors including obese women in their analyses still demonstrated conflicting results 7,14,15 , calling for further studies on the effect of obesity. BMI may affect the IUI outcomes in several aspects.…”

Section: Discussionmentioning

confidence: 99%

“…Especially, underweight women may have a lower chance of getting pregnancy in comparison with normal weight and overweight women. With increasing concerns of the health effect obesity, several authors just ignore underweight women 7 or pooled them with women with normal BMI 14 . However, our data argue that underweight should be considered as well as obesity, when giving consult to patients receiving IUI treatments.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…However, most of the researches were performed in IVF, and the information regarding IUI outcomes in extreme BMI is still controversial. While some authors suggested that high BMI in IUI cycles may reduce response to ovarian stimulation, increase abnormal pregnancy 7 and comprised pregnancy rate 8 , other studies suggested a neutral effect of BMI on IUI outcomes 9,10 . Notably, several authors showed that BMI was positively associated with pregnancy following IUI 11 , suggesting a detrimental effect of underweight rather than obesity.…”

Section: Introductionmentioning

confidence: 99%

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Low BMI is associated with poor IUI outcomes: a retrospective study in 13,745 cycles

Zhen

Cai

Liu

et al. 2021

Preprint

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Objective: To evaluate the association between body mass index (BMI) and pregnancy outcomes in women receiving intrauterine insemination (IUI) treatment． Design: Retrospective cohort study. Setting: University-affiliated hospital. Population: Six thousand four hundred and seven women undergoing 13,745 IUI cycles stratified by body mass index (BMI). Method: Cox regression was used to analyze the association between BMI and cumulative live birth across multiple IUI cycles. GEE was used to analyze the live birth rate per cycle. Main Outcome Measure(s): Cumulative outcomes for IUI cycles. Result(s): Compared with normal weight women (n = 4,563), underweight women (n = 990) had a lower cumulative pregnancy and live birth rate (20.71% vs 25.93%, 17.07% vs 21.61%, respectively), while overweight women (n = 854) had a higher cumulative pregnancy and live birth rate (31.97%, 26.58%). Adjusted for confounders, hazard Ratio (HR) for achieving live birth following up to a maximal of 4 IUI cycles was 0.8(95%CI: 0.67-0.95) comparing underweight with normal weight. In generalized estimating equation (GEE) analyses, low BMI was also associated with a lower per-cycle live birth rate 0.77(95%CI: 0.64-0.92) with adjustment for cycle-specific parameters, including ovarian stimulation, endometrial thickness and follicular diameter. Conclusion(s): Underweight is associated with poor IUI outcomes. Funding: Clinical Research Special Fund of Chinese Medical Association (NO.18010360765) and Xiamen Medical Advantage Subspecialty Construction Project (2018[296])

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Effect of body mass index on intrauterine insemination cycle success

Cited by 18 publications

References 38 publications

Predictors of pregnancy after intrauterine insemination in women with polycystic ovary syndrome

Predictors of pregnancy after intrauterine insemination in women with polycystic ovary syndrome

Obesity and adverse pregnancy outcomes in older patients with decreased ovarian reserve: a retrospective single-centre study

Low BMI is associated with poor IUI outcomes: a retrospective study in 13,745 cycles

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