Live birth outcomes in infertile patients with class III and class IV obesity following fresh embryo transfer

Romanski, Phillip A.; Bortoletto, Pietro; Magaoay, Brady I.; Chung, Alice; Rosenwaks, Zev; Spandorfer, Steven D.

doi:10.1007/s10815-020-02011-1

Cited by 16 publications

(15 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the complications described during pregnancy in obese women is a higher risk of early and late miscarriage [26,27 ▪ ] in both natural and assisted conception [13,28,29], which increases in a BMI-dependent manner [30], and can be reiterative, as in the case of recurrent miscarriage [31]. A recent dose–response meta-analysis [15] in which 13 studies and 235 167 cycles were included in the analysis of miscarriage rates observed a risk ratio of miscarriage of 1.09 [95% confidence interval (CI): 1.05–1.12] per 5-unit increment in BMI.…”

Section: Miscarriage Risk In Obese Womenmentioning

confidence: 99%

BMI and miscarriage after IVF

Bellver

2022

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Purpose of reviewTo summarize recent findings related to the risk of miscarriage in women with elevated BMI undergoing IVF, and the mechanisms involved in said risk.Recent findingsMiscarriage rates are increased in overweight and obese women in both natural and assisted reproduction. Oocyte and embryo quality assessed according to classic morphological static parameters does not seem to be affected by excessive female body weight. Despite the initial lack of consensus between studies regarding embryo morphokinetics in obese women, blastocyst formation and quality have recently been shown to be similar across BMI groups, even in the case of euploid embryos. However, some metabolomic differences have been described in oocytes and embryos from obese women, thus pointing to a functional alteration. In women with elevated BMI, the percentage of aneuploid embryos is similar to that of normal weight women, and rates of miscarriage are higher, despite the transfer of euploid embryos. Therefore, the origin of the increased pregnancy loss rate after IVF in these women may be related to metabolomic, epigenetic or mitochondrial oocyte and embryo disturbances, or to the abnormal endocrine, metabolic and inflammatory uterine environment induced by obesity, which seems to be also responsible for other numerous complications during pregnancy and the in-utero fetal programming of postnatal diseases. A displacement of the window of implantation in obese women undergoing artificial endometrial preparation has recently been described and may be related to the poorer embryo implantation rates and increased risk of miscarriage observed following fresh and frozen embryo transfers with autologous oocytes, and with donated ova in recipients with extremely high BMI.SummaryFemale obesity is related to poorer outcome in natural and assisted conception, including an increased risk of miscarriage. Embryo morphology, assessed by conventional methods or by morphokinetics, does not seem to be affected by excess weight, with similar blastocyst formation and quality than normal weight women reported in IVF cycles. Embryo aneuploidy is not increased, and higher miscarriages rates are seen after euploid embryo transfer in obese women. Disturbances of the uterus or its environment induced by female obesity seem to be the most likely cause of the increased risk of miscarriage, although metabolomic, epigenetic or mitochondrial oocyte and embryo dysfunction cannot be ruled out as cannot congenital anomalies. In the context of all the above, weight reduction before pregnancy should be advised in obese women trying to become pregnant.

show abstract

Section: Miscarriage Risk In Obese Womenmentioning

confidence: 99%

BMI and miscarriage after IVF

Bellver

2022

Current Opinion in Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…There is an essential role of obesity in treatment outcomes in women with PCOS in the interaction with HA. For patients undergoing IVF or intracytoplasmic sperm injection, Romanski et al [ 31 ] showed a significant trend for a decreased LBR and increased miscarriage rate as BMI increased. Furthermore, patients with a BMI >40 kg/m 2 had worse IVF treatment outcomes than normal-weight patients.…”

Section: Discussionmentioning

confidence: 99%

The impact of hyperandrogenism on the outcomes of ovulation induction using gonadotropin and intrauterine insemination in women with polycystic ovary syndrome

Ho¹,

Pham

Nguyễn

et al. 2022

Clin Exp Reprod Med

View full text Add to dashboard Cite

Objective: This study aimed to investigate the impact of hyperandrogenism (HA) on the outcomes of ovulation induction (OI) using gonadotropin and intrauterine insemination (IUI) in patients with polycystic ovary syndrome (PCOS).Methods: This was a retrospective cohort study including 415 patients undergoing OI using gonadotropin and IUI treatment between January 2018 and December 2020 at a single infertility center. Baseline characteristics, clinical and laboratory parameters, and pregnancy outcomes were investigated.Results: Among the study population, there were 105 hyperandrogenic (25.3%) and 310 non-hyperandrogenic patients (74.7%). The live birth rate was lower in the HA group than in the non-HA group, but this difference did not reach statistical significance due to the limited sample size (14.3% vs. 21.0%, relative risk=0.68; 95% CI, 0.41–1.14, p=0.153). No predictive factors for live birth were identified through logistic regression analysis. Conclusion: HA did not negatively affect the outcomes of OI using gonadotropin and IUI cycles in Vietnamese women with PCOS. The result may not be applicable elsewhere due to the large variation in the characteristics of women with PCOS across races and populations.

show abstract

“…One effective way to treat endometriosis is to use GnRH agonists (such as leuprolide acetate), which inhibit estrogen production. However, one of the possible side effects of this treatment is obesity and BMI increasing, which is a concern for some patients (23,24). This study investigated the role of leuprolide acetate in treating overweight patients (BMI≥30) and their comparison with non-overweight patients (BMI<30) for six months.…”

Section: Evaluation Of Mif Gene Expressionmentioning

confidence: 99%

Analysis of the clinical efficacy of leuprolide acetate in the treatment of obese patients with endometriosis and its role on the expression of MIF gene

Zhang

Dong

Zhang

et al. 2022

Cell Mol Biol (Noisy-le-grand)

View full text Add to dashboard Cite

Endometriosis is an invasive but benign disease of women that develops in endometrial glands outside the endometrium and uterine muscle. It affects about 15-20% of women of childbearing age. One effective way to treat endometriosis is to use GnRH agonists, which inhibit estrogen production. However, one of the possible side effects of this treatment is obesity and BMI increasing, which is a concern for some patients. This study investigated the role of leuprolide acetate in treating overweight patients (BMI≥30) and their comparison with non-overweight patients (BMI<30) for six months. Also, the effect of this medicine was evaluated on the expression of the MIF gene, which is an effective gene in obesity. For this purpose, a clinical trial was performed on 75 women with endometriosis aged 18 to 35 years. These patients were divided into two groups. The first group consisted of 38 patients with BMI<30. The second group consisted of 37 patients with BMI≥30. Both groups were treated with leuprolide acetate at a dose of 3.75 mg/month (intramuscularly) for six months. In addition to clinical evaluations, the expression of the MIF gene was assessed by the real-time PCR technique. The results showed that treatment with leuprolide acetate during six months in both groups reduced dysmenorrhea, dyspareunia, and chronic pelvic pain (P<0.05). Although this decrease was greater in the BMI <30 group, the difference was not significant. Also, after collecting the side effects of the medication, it was found that hypoestrogenism, such as cramps and spotting, was more in the first group; Endogenous complications such as oily skin, acne, and hirsutism were also more common in the second group. The results of MIF gene expression showed that the expression level before and after the start of the experiment in the second group (BMI≥ 30) is higher than the first group (BMI <30). The results also showed that the two groups increased the expression of the MIF gene after treatment with leuprolide acetate. This increase was statistically significant in the second group (P = 0.042). Generally, it was found that this medication causes more weight gain in obese people and increases the risk of obesity-related diseases among these patients. Therefore, it is recommended that this treatment be used with caution in obese patients with endometriosis.

show abstract

Live birth outcomes in infertile patients with class III and class IV obesity following fresh embryo transfer

Cited by 16 publications

References 34 publications

BMI and miscarriage after IVF

BMI and miscarriage after IVF

The impact of hyperandrogenism on the outcomes of ovulation induction using gonadotropin and intrauterine insemination in women with polycystic ovary syndrome

Analysis of the clinical efficacy of leuprolide acetate in the treatment of obese patients with endometriosis and its role on the expression of MIF gene

Contact Info

Product

Resources

About