Elevated body mass index (BMI) does not adversely affect in vitro fertilization outcome in young women

Abstract

Obesity in young women does not adversely affect clinical pregnancy rates in patients treated with in vitro fertilization.

The adverse effects of obesity on conception and implantation

“…A high prevalence of PCOS was seen in the obese category; therefore, the authors performed subset analyses comparing the BMI strata in the PCOS and non-PCOS groups. Whilst no significant differences were observed in the non-PCOS obese groups, it was observed that obesity in women with PCOS lead to a significant reduction in implantation and ongoing pregnancy rates (Martinuzzi et al 2008). Additionally, an interesting finding was that obese women were significantly more likely to encounter difficulty in observing the air bubble during ultrasound-guided embryo transfer and were more likely to have blood on or in the catheter after embryo transfer, factors which have been associated with poorer success rates after embryo transfer (Martinuzzi et al 2008).…”

“…In this study, obese patients had significantly lower ovulation rates at 6 months of treatment: 79% in women with BMI of 18-24 kg/m . Some authors, however, have been unable to demonstrate any difference in ovarian response to stimulation in obese women (Lashen et al 1999, Dechaud et al 2006, Martinuzzi et al 2008.…”

“…It is thought that this is the cumulative effect of lower implantation and pregnancy rates, higher miscarriage rates and increased obstetric complications (Bellver et al 2006). Whilst some authors have reported lower pregnancy and live birth rates in obese women undergoing assisted conception treatments (Wang et al 2000, Carrell et al 2001, Loveland et al 2001, Fedorcsak et al 2004, Bellver et al 2010, others have been unable to demonstrate reduction in success rates in obese women (Lashen et al 1999, Wittemer et al 2000, Dechaud et al 2006, Martinuzzi et al 2008, Matalliotakis et al 2008. A retrospective analysis of outcomes in 3586 patients undergoing IVF/ICSI/GIFT observed that the cumulative chance of achieving at least one pregnancy was significantly reduced in the obese women when compared to normal controls Wang et al 2000).…”

The impact of body mass index on assisted reproduction

“…Dokras et al [12] have emphasized that the obese women (with BMI > 40 kg/m 2 ) with PCOS had a lower ART cycle cancellation rate and fewer days of gonadotrophin stimulation than those without PCOS. Martinuzzi et al [23] have recently suggested that though total gonadotrophin dose was similar among all BMI groups, starting gonadotrophin dose was significantly lower in PCOS patients. In contrast, some authors have claimed that the presence of PCOS did not positively affect the duration of ovulation induction, cancellation rates and gonadotrophin dose [9].…”

“…However, there are some studies showing no significant adverse effect of obesity on ovarian response during COH in ART cycles [14,21,23]. In addition, some other studies have revealed that obesity actually decreases the need for gonadotrophins [11,[20][21][22]24] and the number of days of ovarian stimulation [17,21,24] and does not affect the estradiol levels [9,[14][15][16][17][18]23,25].…”