Low body mass index compromises live birth rate in fresh transfer in vitro fertilization cycles: a retrospective study in a Chinese population

Cai, Jiali; Liu, Lanlan; Zhang, Junwen; Qiu, Huiling; Jiang, Xiaoming; Li, Ping; Sha, Aihua; Ren, Jianzhi

doi:10.1016/j.fertnstert.2016.10.029

Cited by 55 publications

(58 citation statements)

References 27 publications

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“…On the day of triggering, the median peak E 2 level was 4389 (2779-6307.5) pg/ml and the mean progesterone level 1.46 AE 1.71 ng/ml. The median oocyte number was 13 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The number of oocytes was significantly associated Supporting Information Tables S2 and S5), the E 2 level as a continuous variable was negatively associated with both the z-score and the birthweight of the newborns (adjusted P-value 0.009 and 0.01, respectively).…”

Section: Resultsmentioning

confidence: 97%

“…In stimulation cycles, all patients received an agonist or antagonist protocol with the use of FSH or hMG as previously described. 16 Physicians adjusted the starting dose according to the age of patients, body mass index (BMI) and antral follicle count (AFC) and administered hCG when at least one follicle reached a mean diameter of 18 mm as determined by ultrasonography. Oocytes were recovered 34-36 hours after hCG administration under transvaginal ultrasound guidance and were inseminated using either conventional IVF or intracytoplasmic sperm injection (ICSI).…”

Section: Ovarian Stimulation and Laboratory Protocolmentioning

confidence: 99%

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Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study

Cai

Liu

et al. 2019

BJOG

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Objective To investigate whether supraphysiological estradiol (E2) in controlled ovarian stimulation (COS) cycles affects the subsequent frozen‐thawed embryo transfer (FET) in terms of the neonatal birthweight. Design Retrospective cohort study. Setting University affiliated hospital. Population In all, 2066 patients undergoing FET cycles that resulted in live singleton births between July 2011 and Dec 2016. Interventions None. Methods Multivariable linear regression and logistic regression was used to evaluate the association between peak E2 and birthweight outcomes. Main outcome measures Birthweight, z‐score adjusted for gender and gestational age, and incidence of small‐for‐gestational‐age (SGA) and low birthweight (LBW) in singleton neonates derived from FET cycles. Results Adjusted for confounding factors, both the absolute birthweight and the z‐score of singletons following FET were negatively associated with peak E2 levels in COS. In comparison with the referent category (E2 ≤1500 pg/ml), the categories with E2 >3000 pg/ml had a significantly lower z‐score. The difference (95% CI) in estimated marginal mean of birthweights between referent category and highest E2 (>8000 pg/ml) category was 104.57 g (18.13–181.06). Multiple logistic regression analyses showed that the adjusted odds ratio (95% CI) for SGA and LBW in term singletons comparing patients with E2 >3000 pg/ml with those with E2 ≤3000 pg/ml was 2.44 (1.37–4.34) and 2.32 (1.01–5.40), respectively. Conclusions Peak E2 levels in COS cycles are negatively associated with the birthweight of singletons conceived through subsequent FET cycles. Tweetable abstract The birthweight following FET is affected by previous COS cycle.

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Section: Resultsmentioning

confidence: 97%

Section: Ovarian Stimulation and Laboratory Protocolmentioning

confidence: 99%

Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study

Cai

Liu

et al. 2019

BJOG

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“…Most studies (4,(17)(18)(19) failed to demonstrate the association between low BMI and impaired IVF outcome. However, Cai et al (3) recently concluded that low BMI is associated with negative outcomes in fresh transfer cycles, especially in women of advanced age. Obviously, in Cai's study only fresh transfer cycles were included, and frozen embryo transfers and cases with canceled fresh transfers were both excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have shown that a body mass index (BMI) that is either too high or too low is associated with a reduced probability of achieving pregnancy in women undergoing assisted reproductive technology (ART) (1). However, most of these studies are limited by being cycle-based (2)(3)(4)(5), in which they only studied fresh cycles and reported the outcome in terms of live births per fresh cycle or embryo transfer. There cannot be a complete measure of an in vitro fertilization (IVF) treatment's success without a comprehensive analysis of the frozen embryo transfer (FET).…”

Section: Introductionmentioning

confidence: 99%

Cumulative Live Birth Rates According to Maternal Body Mass Index After First Ovarian Stimulation for in vitro Fertilization: A Single Center Analysis of 14,782 Patients

et al. 2020

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Objective: To investigate the cumulative live birth rates (CLBR) according to body mass index (BMI) in women undergoing their first in vitro fertilization (IVF). Design: Retrospective cohort analysis. Setting: An IVF clinic in a public hospital. Patients: This is a retrospective study of 14,782 patients undergoing their first fresh IVF cycles and subsequent frozen embryo transfers in our clinic from January 2014 to January 2017. The follow-up for CLBR continued until January 2019. Patients with a BMI <18.5 kg/m 2 were considered to be underweight and those with a BMI > 24 kg/m 2 were considered to be overweight. Patients with a BMI ≥ 28 kg/m 2 were considered to be obese. Intervention(s): None. Primary Outcome Measure: The primary outcome was cumulative live birth rate (CLBR). Result(s): This study illustrated the "inverted U shape" associations between body weight and IVF outcome (CLBR). The turning points in threshold analysis, as found by an automatic search, were BMIs of 18.5 and 30.4 kg/m 2. The main finding of this retrospective data analysis is that the CLBR increased in underweight women, plateaued for normal weight and overweight women with a BMI between 18.5 and 30.4 kg/m 2 , and decreased in obese women. Conclusion(s): The data suggested an "inverted U shape" association between BMI and CLBR. The CLBR increases in underweight women, plateaus in normal weight and overweight women, and then decreases in obese women.

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“…Top-quality embryos were defined as those with at least seven blastomeres, even cleavage and <5% fragmentation (Grade I) on day 3, or those with an expansion stage ≥3 and morphologically good inner cell mass and trophectoderm (Grade AA) on day 5/6. 24 Luteal phase support was sustained until 10 weeks of gestation if a pregnancy was achieved.…”

Section: Key Messagementioning

confidence: 99%

Effect of a prior cesarean delivery on pregnancy outcomes of frozen‐thawed embryo transfer: A retrospective cohort study in a freeze‐all setting

Huang

Lin

Cai

et al. 2020

Acta Obstet Gynecol Scand

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Introduction The association between the mode of previous delivery and subsequent success of assisted reproductive treatment has been poorly understood. By mitigating the detrimental effect of supraphysiologic estradiol levels on endometrial receptivity, a freeze‐all strategy provides a novel model to investigate the sole impact of a prior cesarean delivery (CD) on embryo transfer outcomes. Material and methods This single‐center retrospective cohort study included 2660 patients who underwent their first frozen‐thawed embryo transfer cycles after a freeze‐all policy from January 2013 to December 2018. Patients with a history of live birth by CD were assigned to the CD group, and those with only vaginal delivery (VD) were categorized into the VD group. The primary outcome measure was live birth. Baseline characteristics of the two groups were balanced by propensity score matching in a ratio of 1:1. Univariate and multivariate logistic regression analyses were performed using the after‐matching data. Results Compared with the VD group, the rates of clinical pregnancy (38.3% vs 44.5%; P = .005) and live birth (27.5% vs 33.4%; P = .003) were significantly lower in women with a history of CD. When adjusted for a number of major confounding factors, the negative association between a prior CD and frozen‐thawed embryo transfer success was maintained, with the adjusted odds ratio (OR) being 0.80 (95% CI 0.66‐0.96) and 0.78 (95% CI 0.63‐0.95) for clinical pregnancy and live birth, respectively. Furthermore, a CD history conferred a marginally increased risk of early miscarriage (crude OR 1.48, 95% CI 1.04‐2.11; adjusted OR 1.47, 95% CI 1.01‐2.14), whereas the odds of multiple and ectopic pregnancy did not show significant differences before and after adjustment. Conclusions A prior CD was associated with a decreased chance of live birth and an increased risk of early miscarriage in frozen‐thawed embryo transfer cycles.

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Low body mass index compromises live birth rate in fresh transfer in vitro fertilization cycles: a retrospective study in a Chinese population

Abstract: Low BMI is associated with negative outcomes in fresh transfer cycles, especially for women of advanced age.

Cited by 55 publications

References 27 publications

Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study

Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study

Cumulative Live Birth Rates According to Maternal Body Mass Index After First Ovarian Stimulation for in vitro Fertilization: A Single Center Analysis of 14,782 Patients

Effect of a prior cesarean delivery on pregnancy outcomes of frozen‐thawed embryo transfer: A retrospective cohort study in a freeze‐all setting

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