Lifestyle intervention prior to IVF does not improve embryo utilization rate and cumulative live birth rate in women with obesity: a nested cohort study

Wang, Zheng; Groen, Henk; Zomeren, K. C. van; Cantineau, Astrid E. P.; Oers, Anne Van; Montfoort, Aafke P.A. van; Kuchenbecker, Walter K. H.; Pelinck, M. J.; Broekmans, Frank J.; Klijn, Nicole F.; Kaaijk, Eugenie M.; Mol, Ben Willem J.; Hoek, Annemieke; Echten-Arends, Jannie van

doi:10.1093/hropen/hoab032

Cited by 8 publications

(5 citation statements)

References 36 publications

(41 reference statements)

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“…this was only seen in one of the 2 studies investigating this. Weight loss below 7% in either males or females did not significantly alter the number of normal fertilized, good quality, and transferred embryos (P > 0.05) [12,13] . Greater than 7% BMI reduction resulting from bariatric surgery significantly increased the number of top-quality embryos compared with their results before surgery only in male participants (P < 0.05) [14,15] .…”

Section: Shorter Time To Embryo Division Into 3 Cells and Reduced Fer...mentioning

confidence: 88%

Obesity and fertility: a literature review of the association between parental obesity at the time of conception and embryo quality

Fufezan,

Mocanu

2023

Global Reproductive Health

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Obesity [body mass index (BMI) ≥ 30 kg/m 2 ] has been shown to be a risk factor in reducing the rate of successful in vitro fertilization (IVF) outcomes. In this systematized literature review, we investigate whether embryo quality specifically is affected by single-parent obesity (maternal or paternal) and obesity in both parents at the time of conception. We systematically searched for studies published over the last 10 years that graded embryo quality in conventional IVF and intracytoplasmic sperm injection procedures. Studies that did not use measured weight and height for BMI calculation were excluded. Ten eligible articles were found across 13 public databases. Comparing the results of 1845 couples, both female and male obesity independently caused faster preimplantation embryo development (P <0.05). The fertilization rate was not affected by either female, male, or combined parental obesity (P > 0.05). Day 3 embryo quality does not seem to be affected by either female or male obesity alone. The 2 studies that investigated the effect of combined parental obesity on embryo quality reached contradictory findings. Male, but not female, > 7% BMI reduction following bariatric surgery significantly increased the number of top-quality embryos compared with their results before surgery (P < 0.05). We conclude that embryos of couples with single-parent obesity are not of lower quality compared with those of normal-weight parents. Combined parental obesity may affect embryo quality. BMI reduction could lead toward a successful outcome in obese infertile couples, regardless of whether they are undergoing IVF or not.

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Section: Shorter Time To Embryo Division Into 3 Cells and Reduced Fer...mentioning

confidence: 88%

Obesity and fertility: a literature review of the association between parental obesity at the time of conception and embryo quality

Fufezan,

Mocanu

2023

Global Reproductive Health

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“…2 ), consistent with previous studies ( 32 ). Most previous studies focused on the effects of maternal underweight (<18.5 kg/m 2 ) and overweight (24–28 kg/m 2 ) on pregnancy outcomes ( 36 , 37 ), while some studies combined obese and overweight patients in their analysis ( 38 , 39 ). Here, obese and overweight patients were separated, in which case embryonic development-related indicators and CLBR were found to increase in underweight group but decreased in the overweight ( Table 2 ), as reported in the 2008–2013 United States Society for Assisted Reproductive Technology registry ( 40 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of BMI on cumulative live birth rates in patients that completed IVF treatment: a retrospective cohort study of 16,126 patients

Zheng,

Zhang,

et al. 2024

Endocrine Connections

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Although several studies have reported that high maternal BMI could influence the cumulative live birth rate (CLBR) in fresh embryo transfer cycles, the association of BMI with CLBR remains unclear in patients treated with complete IVF. In this study, we examined the association of maternal BMI with CLBR, including repetitive one oocyte pick-up (OPU) and all fresh and frozen embryo transfer until live birth or embryos were run out. A total of 16,126 patients’ data were included in the analysis and were divided into four groups based on BMI. We found that patients' characteristics, embryo parameters, and pregnancy outcomes differed among different BMI groups. Multivariate logistic regression showed that being underweight was associated with a higher possibility of having live birth than the reference group [OR (95% CI), 1.40 (1.22-1.59), p<0.001], whereas being overweight and obese were associated with a lower possibility of having live birth than the reference group ([OR (95% CI), 0.81 (0.74-0.90), p<0.001] and [OR (95% CI), 0.68 (0.55-0.85), p<0.001]). After adjustment for confounding factors, the reference group was associated with a higher possibility of having live birth, with a significant difference found between the obese and reference groups [OR (95% CI), 0.55 (0.43-0.70), p<0.001]. An association was found between CLBR and BMI, indicating that an increase in BMI results in a decline in CLBR. Moreover, the CLBR of patients with different characteristics differed in the various BMI groups. Taken together, our data show that maternal BMI has a significant impact on CLBR.

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“…Certain lifestyle behaviours, such as cigarette smoking, alcohol consumption or caffeine, have been associated with lower ART success rates ( Kinney et al , 2007 ; Hornstein, 2016 ; Ozbakir and Tulay, 2021 ). However, while association studies abound, evidence from well-designed intervention studies demonstrating an improvement in ART outcomes following short and/or long-term lifestyle changes remains scarce ( Freour et al , 2018 ; Kermack et al , 2020 ; Wang et al , 2021 ).…”

Section: Investigations For Rifmentioning

confidence: 99%

ESHRE good practice recommendations on recurrent implantation failure

Cimadomo

Santos

Griesinger

et al. 2023

Human Reproduction Open

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STUDY QUESTION How should recurrent implantation failure (RIF) in patients undergoing ART be defined and managed? SUMMARY ANSWER This is the first ESHRE good practice recommendations paper providing a definition for RIF together with recommendations on how to investigate causes and contributing factors, and how to improve the chances of a pregnancy. WHAT IS KNOWN ALREADY RIF is a challenge in the ART clinic, with a multitude of investigations and interventions offered and applied in clinical practice, often without biological rationale or with unequivocal evidence of benefit. STUDY DESIGN, SIZE, DURATION This document was developed according to a predefined methodology for ESHRE good practice recommendations. Recommendations are supported by data from the literature, if available, and the results of a previously published survey on clinical practice in RIF and the expertise of the working group. A literature search was performed in PubMed and Cochrane focussing on ‘recurrent reproductive failure’, ‘recurrent implantation failure’, and ‘repeated implantation failure’. PARTICIPANTS/MATERIALS, SETTING, METHODS The ESHRE Working Group on Recurrent Implantation Failure included eight members representing the ESHRE Special Interest Groups for Implantation and Early Pregnancy, Reproductive Endocrinology, and Embryology, with an independent chair and an expert in statistics. The recommendations for clinical practice were formulated based on the expert opinion of the working group, while taking into consideration the published data and results of the survey on uptake in clinical practice. The draft document was then open to ESHRE members for online peer review and was revised in light of the comments received. MAIN RESULTS AND THE ROLE OF CHANCE The working group recommends considering RIF as a secondary phenomenon of ART, as it can only be observed in patients undergoing IVF, and that the following description of RIF be adopted: ‘RIF describes the scenario in which the transfer of embryos considered to be viable has failed to result in a positive pregnancy test sufficiently often in a specific patient to warrant consideration of further investigations and/or interventions'. It was agreed that the recommended threshold for the cumulative predicted chance of implantation to identify RIF for the purposes of initiating further investigation is 60%. When a couple have not had a successful implantation by a certain number of embryo transfers and the cumulative predicted chance of implantation associated with that number is greater than 60%, then they should be counselled on further investigation and/or treatment options. This term defines clinical RIF for which further actions should be considered. Nineteen recommendations were formulated on investigations when RIF is suspected, and 13 on interventions. Recommendations were colour-coded based on whether the investigations/interventions were recommended (green), to be considered (orange), or not recommended, i.e. not to be offered routinely (red). LIMITATIONS, REASONS FOR CAUTION While awaiting the results of further studies and trials, the ESHRE Working Group on Recurrent Implantation Failure recommends identifying RIF based on the chance of successful implantation for the individual patient or couple and to restrict investigations and treatments to those supported by a clear rationale and data indicating their likely benefit. WIDER IMPLICATIONS OF THE FINDINGS This article provides not only good practice advice but also highlights the investigations and interventions that need further research. This research, when well-conducted, will be key to making progress in the clinical management of RIF. STUDY FUNDING/COMPETING INTEREST(S) The meetings and technical support for this project were funded by ESHRE. N.M. declared consulting fees from ArtPRED (The Netherlands) and Freya Biosciences (Denmark); Honoraria for lectures from Gedeon Richter, Merck, Abbott, and IBSA; being co-founder of Verso Biosense. He is Co-Chief Editor of Reproductive Biomedicine Online (RBMO). D.C. declared being an Associate Editor of Human Reproduction Update, and declared honoraria for lectures from Merck, Organon, IBSA, and Fairtility; support for attending meetings from Cooper Surgical, Fujifilm Irvine Scientific. G.G. declared that he or his institution received financial or non-financial support for research, lectures, workshops, advisory roles, or travelling from Ferring, Merck, Gedeon-Richter, PregLem, Abbott, Vifor, Organon, MSD, Coopersurgical, ObsEVA, and ReprodWissen. He is an Editor of the journals Archives of Obstetrics and Gynecology and Reproductive Biomedicine Online, and Editor in Chief of Journal Gynäkologische Endokrinologie. He is involved in guideline developments and quality control on national and international level. G.L. declared he or his institution received honoraria for lectures from Merck, Ferring, Vianex/Organon, and MSD. He is an Associate Editor of Human Reproduction Update, immediate past Coordinator of Special Interest Group for Reproductive Endocrinology of ESHRE and has been involved in Guideline Development Groups of ESHRE and national fertility authorities. D.J.M. declared being an Associate Editor for Human Reproduction Open and statistical Advisor for Reproductive Biomedicine Online. B.T. declared being shareholder of Reprognostics and she or her institution received financial or non-financial support for research, clinical trials, lectures, workshops, advisory roles or travelling from support for attending meetings from Ferring, MSD, Exeltis, Merck Serono, Bayer, Teva, Theramex and Novartis, Astropharm, Ferring. The other authors had nothing to disclose. DISCLAIMER This Good Practice Recommendations (GPR) document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and are based on the scientific evidence available at the time of preparation. ESHRE GPRs should be used for information and educational purposes. They should not be interpreted as setting a standard of care or be deemed inclusive of all proper methods of care, or be exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, or variations based on locality and facility type. Furthermore, ESHRE GPRs do not constitute or imply the endorsement, or favouring, of any of the included technologies by ESHRE.

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Lifestyle intervention prior to IVF does not improve embryo utilization rate and cumulative live birth rate in women with obesity: a nested cohort study

Cited by 8 publications

References 36 publications

Obesity and fertility: a literature review of the association between parental obesity at the time of conception and embryo quality

Obesity and fertility: a literature review of the association between parental obesity at the time of conception and embryo quality

Effect of BMI on cumulative live birth rates in patients that completed IVF treatment: a retrospective cohort study of 16,126 patients

ESHRE good practice recommendations on recurrent implantation failure

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