Effect of Obesity on Oocyte and Embryo Quality in Women Undergoing In Vitro Fertilization

Shah, Divya; Missmer, Stacey A.; Berry, Katharine; Racowsky, Catherine; Ginsburg, Elizabeth S.

doi:10.1097/aog.0b013e31821fd360

Cited by 216 publications

(153 citation statements)

References 34 publications

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“…The largest study in the literature on oocyte and embryo parameters reported fewer than two pronuclei embryos, lower clinical pregnancy, and live birth rates in their obese patients [16] compared with normal-weight controls. In this study, there was no association between obesity and the quality of day 3 embryos.…”

Section: Introductionmentioning

confidence: 99%

Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization

Comstock

Kim

Behr

et al. 2015

J Assist Reprod Genet

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Purpose The aim of this study is to investigate the effect of female BMI and metabolic dysfunction on blastocyst formation rate. Methods This was a retrospective cohort study that was performed in an academic center for reproductive medicine. Patients who were normal weight, overweight with metabolic dysfunction, or obese who had ≥6 oocytes retrieved in a fresh IVF cycle were included in the study. The blastocyst formation rate was calculated from the number of ≥5 cell embryos on day 3 observed in culture until day 5 or day 6. Only good quality blastocysts were included in the calculation as defined by a morphologic grade of 3BB or better. Results The blastocyst formation rate was significantly better in the normal-weight controls versus overweight/obese patients (57.2 versus 43.6 %, p<0.007). There was no difference in blastocyst formation between the patients with a BMI 25-29.9 kg/m 2 with metabolic dysfunction and those with a BMI ≥30 kg/m 2 . Conclusion The maternal metabolic environment has a significant impact on embryo quality as measured by blastocyst formation. A decreased blastocyst formation rate is likely a significant contributor to poorer reproductive outcomes in overweight and obese women with infertility.

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Section: Introductionmentioning

confidence: 99%

Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization

Comstock

Kim

Behr

et al. 2015

J Assist Reprod Genet

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“…However, lean women achieved higher CPR and live birth rate compared to the overweight and obese women. It is assumed that obesity alters the follicular androgen profile, insulin resistance and is associated with elevated leptin levels which inversely affect oocyte size, oocyte and embryo quality; changes that may be responsible for the poor outcome in overweight and obese PCOS women 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…In non-PCOS women, BMI has been shown to affect IVF outcome 10,11 . However, in women with PCOs, the effect of BMI on IVF/ICSI outcome has not been fully evaluated.…”

Section: Introductionmentioning

confidence: 99%

Useeffect of Body Mass Index on in Vitro Fertilization/Intra-Cytoplasmic Sperm Injection Outcome in Egyptian Women with Polycystic Ovary Syndrome

Mahran

2017

Evidence Based Women's Health Journal

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Objectives: To investigate the effect of body mass index (BMI) on outcome of IVF/ICSI in Egyptian women with PCOS.Study design: Retrospective cohort study. Patients And Methods: The study included including 253 women with PCOS (study group) and 253 women with tubal or unexplained infertility (control group) that underwent IVF/ICSI treatment at Minia IVF Center in Egypt in the period between January 2013 and December 2015. Results: The number of retrieved oocytes and the total number of embryos were significantly higher in women with PCOS compared to the control group (P=0.003 and 0.002 respectively). There was no significant difference between the two groups as regards the clinical pregnancy rate (CPR), live birth rate and miscarriage rate. More cases of ovarian hyperstimulation syndrome (OHSS) were diagnosed in the PCOS group (24 vs. 5. P=0.3). When stratified for BMI, lean PCOS women (BMI< 25) had higher CPR (35% vs. 28.2, P=0.01), live birth rate (32% vs. 26.1%, P =0.01). There were more cases of OHSS in lean as compared with overweight and obese PCOS women (19% vs. 3.3%, P = 0.05). Conclusion: Lean PCOS women achieved higher CPR and live birth rate in IVF/ICSI compared to overweight and obese PCOS women in Egyptian population.

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“…Patient concern that being overweight or obese is detrimental to IVF success may contribute to the finding that over 60 % of survey respondents considered it helpful for men and women to exercise rigorously during the IVF cycle [2,3,14]. While the impact of rigorous exercise during the IVF cycle has not been completely characterized, existing literature suggests vigorous exercise, whether current or former, is associated with worse outcomes [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Studies suggest certain lifestyle behaviors and patient characteristics such as being underweight or obese adversely affect cycle success [2,3], while stress-reducing behaviors are generally thought to be beneficial [4,5]. Meanwhile, some popularly supported behaviors, such as complete bed rest after embryo transfer, have not been shown to improve outcomes [6,7].…”

Section: Introductionmentioning

confidence: 99%

Perceptions among infertile couples of lifestyle behaviors and in vitro fertilization (IVF) success

Hawkins

Rossi

Correia

et al. 2014

J Assist Reprod Genet

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Purpose To assess how patients perceive various lifestyle behaviors impact IVF success. Methods Cross-sectional study of heterosexual, Englishspeaking couples (n=138) who completed web-based surveys during IVF treatment cycle. Perceived impact of lifestyle choices assessed by multivariable logistic regression and pvalue tests for linear trend (P t ). Result(s) During the IVF cycle, most patients consider it helpful for women to exercise (76 %), avoid stress (87 %) and limit activity after embryo transfer (92 %). The majority of patients (62 %) consider rigorous exercise (4+ h/week) helpful and nearly one-third (32 %) perceive benefit to complete bed rest after transfer. Overall, couples with a sexspecific infertility diagnosis are more likely to consider partner's lifestyle choices impactful: male-factor couples are more likely to consider it helpful for men to limit cellular phone use (OR:2.73,CI:1.06-7.04) and diminished ovarian reserve couples are more likely to consider it helpful for women to limit exposure to plastics (OR:2.38,CI:1.03-5.51). Patients at higher levels of education (P t <0.01) and income (P t <0.01) are less likely to consider lifestyle impactful. Conclusion(s) Patient perceptions of the impact of lifestyle factors on IVF success vary by sex, infertility diagnosis and socioeconomic factors. Despite counseling to the contrary, many patients perceive benefit to rigorous exercise during the IVF cycle and complete bedrest following transfer. Results provide insight into patient beliefs and highlight opportunities to improve patient education, alleviate patient anxieties and potentially improve IVF outcomes.

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Effect of Obesity on Oocyte and Embryo Quality in Women Undergoing In Vitro Fertilization

Abstract: Obesity was associated with fewer normally fertilized oocytes, lower estradiol levels, and lower pregnancy and live birth rates. Infertile women requiring IVF should be encouraged to maintain a normal weight during treatment.

Cited by 216 publications

References 34 publications

Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization

Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization

Useeffect of Body Mass Index on in Vitro Fertilization/Intra-Cytoplasmic Sperm Injection Outcome in Egyptian Women with Polycystic Ovary Syndrome

Perceptions among infertile couples of lifestyle behaviors and in vitro fertilization (IVF) success

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