Maternal body mass index associates with blastocyst euploidy and live birth rates: the tip of an iceberg?

Fabozzi, Gemma; Cimadomo, Danilo; Allori, Mariachiara; Vaiarelli, Alberto; Colamaria, Silvia; Argento, Cindy; Amendola, Maria Giulia; Innocenti, Federica; Soscia, Daria; Maggiulli, Roberta; Mazzilli, Rossella; Ubaldi, Nicolò; Iussig, Benedetta; Marchetti, Marco; Rienzi, Laura; Ubaldi, Filippo Maria

doi:10.1016/j.rbmo.2021.07.006

Cited by 13 publications

(7 citation statements)

References 76 publications

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“…Moreover, Boynukalin et al [41 ▪▪ ] have recently shown that the growth rate of embryos has no effect on miscarriage rates after single frozen euploid blastocyst transfer among women with higher BMI who presented an increased risk of miscarriage. Fabozzi et al [42] observed a higher risk of miscarriage after single euploid blastocyst transfer in women with a BMI higher than 25 kg/m 2 , even when results were adjusted by blastocyst morphological quality and day of full blastulation. In summary, static or dynamic morphological embryo assessment does not seem to explain the deleterious effect of female BMI on assisted reproduction outcome, or to be related to an increased risk of miscarriage.…”

Section: Cause Of Miscarriage In Obese Womenmentioning

confidence: 98%

BMI and miscarriage after IVF

Bellver

2022

Current Opinion in Obstetrics &Amp; Gynecology

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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.

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Section: Cause Of Miscarriage In Obese Womenmentioning

confidence: 98%

BMI and miscarriage after IVF

Bellver

2022

Current Opinion in Obstetrics &Amp; Gynecology

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“…Several studies reported that PCOS patients showed a higher miscarriage rate than non‐PCOS patients 82,84 except for women with a tubal factor, 89 similar to what observed in women with obesity compared to those with normal weight 90 . According to these results, two recent studies evaluating preimplantation genetic testing ICSI cycles and euploid blastocyst transfers highlighted an increased risk of miscarriage in case of overweight and obesity 91 . Going in the same direction, Bu et al found that PCOS significantly increased the spontaneous miscarriage rate, but only in patients younger than 35 years old 92 .…”

Section: Clinical Aspects Of Dysmetabolic Infertilitymentioning

confidence: 71%

Female infertility in the era of obesity: The clash of two pandemics or inevitable consequence?

Medenica

Spoltore

Ormazábal

et al. 2022

Clinical Endocrinology

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Obesity is an epidemic that has led to a rise in the incidence of many comorbidities: among others, reduced fertility is often under-evaluated in clinical practice. The mechanisms underlying the link between reduced fertility and obesity are numerous, with insulin resistance, hyperglycaemia and the frequent coexistence of polycystic ovary syndrome being the most acknowledged. However, several other factors concur, such as gut microbiome alterations, low-grade chronic inflammation and oxidative stress. Not only do women with obesity take longer to conceive, but in vitro fertilization (IVF) is also less likely to succeed. We herein provide an updated state-of-the-art regarding the molecular bases of what we could define as dysmetabolic infertility, focusing on the clinical aspects, as well as possible treatment.

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“…Because of the excess of free fatty acids in reproductive tissues and organs, obese women are more prone to ovulatory dysfunction, increased polycystic ovarian syndrome, anovulation, reduced fecundity, poorer IVF success, early pregnancy complications and loss, fetal congenital anomalies and deaths, and generalized delayed time to pregnancy [137]. Recently, an observational study aimed at correlating body mass index and embryo competence and/or endometrial receptivity has confirmed that the maternal body being overweight is responsible for higher miscarriage rate, suggesting a possible lipotoxic mechanism exerted by incorrect body fat mass and distribution [138]. Obesity seems also to affect the oocyte and the preimplantation embryos, due to disruption of meiotic spindle and mitochondrial activities [139,140].…”

Section: Diet and Behavior Impact On Female Reproductive Healthmentioning

confidence: 99%

Reprotoxic Impact of Environment, Diet, and Behavior

Gallo

2022

IJERPH

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Reproductive health is progressively declining due to multiples endogenous and exogenous factors, such as environmental contaminants, diet and behavior. Accumulated evidences confirm that fertility and reproductive function have been adversely affected by exposure to chemical contaminants released in the environment. Today, the impact of diet and behavior on reproductive processes is also receiving special attention from the scientific community. Indeed, a close relationship between diet and fertility has been proven. Furthermore, a combination of unhealthy behavior, such as exposure to hazardous compounds and stress factors, poses living organisms at higher risk of reprotoxic effects. In particular, it has been described that poor life behaviors are associated with reduced male and female fertility due to decreased gamete quality and function. Most of the erroneous behaviors are, furthermore, a source of oxidative stress that, leading to epigenetic alterations, results in an impaired reproductive fitness. This review reports the detrimental impact of the most common environmental chemical stressors, diet, and behavior on reproductive functionality and success. Although clear evidences are still scarce, reassuring data are provided that a healthy diet and reverting unhealthy lifestyles may be of help to recover physiological reproductive conditions.

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Maternal body mass index associates with blastocyst euploidy and live birth rates: the tip of an iceberg?

Cited by 13 publications

References 76 publications

BMI and miscarriage after IVF

BMI and miscarriage after IVF

Female infertility in the era of obesity: The clash of two pandemics or inevitable consequence?

Reprotoxic Impact of Environment, Diet, and Behavior

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