Impact of body mass index on IVF and ICSI outcome: a retrospective study

doi:10.1016/S1472-6483(10)60142-3

Reproductive BioMedicine Online

Volume 16, Issue 6, 2008, Pages 778-783

https://doi.org/10.1016/S1472-6483(10)60142-3 Get rights and content

Abstract

A group of 140 women with a body mass index (BMI) ≤24 kg/m² undergoing 291 cycles was compared with a group of 138 women with a BMI >24 kg/m² in 291 cycles, with respect to duration of ovarian stimulation and dose of gonadotrophin, number of oocytes collected, cleavage and implantation rate, clinical pregnancy, miscarriage and delivery rates. Patients with a BMI > 24 kg/m² demonstrated a significant decrease in the number of follicles after stimulation (P = 0.01), a comparative increase in the number ampoules of gonadotrophin used (P = 0.03) and a lower number of eggs collected (P = 0.05). The mean number of embryos on days 1, 2 and 3 was significantly lower in the group with BMI > 24 kg/m² (P < 0.001). No significant difference was found in clinical pregnancy and miscarriage rates between the two groups. In spite of the lower response in women with BMI > 24 kg/m², the delivery rate per retrieval was not different (24.6 versus 24.8%). These results indicate a lower stimulation response in women with elevated BMI, but no adverse effect on IVF outcome. In relation to wellbeing, however, it is recommended that patients with a high BMI reduce their weight before IVF treatment.

Section snippets

Ioannis Matalliotakis graduated in 1979 from the University of Thessaloniki with an MD. He completed his specialization in Obstetrics and Gynecology in 1988 and received his PhD in 1989. He was appointed as Lecturer at the University of Crete in 1990 and in 1995 he was promoted to Assistant Professor. In 2001 and 2004 he was a visiting Assistant Professor at the University of Yale and in 2006 he was promoted to Associate Professor. He has published more than 100 international papers, most of

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Cited by (70)

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2022, European Journal of Obstetrics and Gynecology and Reproductive Biology
As the number of overweight and obese women seeking assisted reproductive care increases, interest in understanding the effects of excess weight on fertility is also increasing. Therefore, a systematic review and meta-analysis were performed to evaluate the associations of overweight and obesity with assisted reproductive technology outcomes. The following databases were searched through March 2019: MEDLINE (PubMed), Embase, Scopus, Lilacs, Web of Science, Clinical Trials and SciELO. The keywords used were obesity, overweight and assisted reproduction, as well as similar terms. Articles were selected based on titles and abstracts. Potentially relevant studies were evaluated for inclusion by two reviewers. Subsequently, quality was assessed using the Newcastle–Ottawa Quality Assessment Scale. The meta-analysis was performed using a random-effects model. Sensitivity analyses were performed to investigate sources of heterogeneity, as recommended by the Cochrane Collaboration. In total, 53 studies with 1,445,406 treatment cycles were included. When analysing one cycle per patient, being overweight or obese was found to have a weak negative impact on clinical pregnancy, livebirth and miscarriage rates; number of mature oocytes; duration of ovarian stimulation; and gonadotropin dosage used among the exposed women. Therefore, an increased body mass index is associated with weak adverse outcomes among women undergoing in-vitro fertilization or intracytoplasmic sperm injection. This study searched a greater number of research databases and analysed a greater number of studies with good methodological quality and low or moderate heterogeneity, including a greater number of assisted reproduction treatment cycles, than other studies conducted to date. Nevertheless, more robust studies on the subject are needed to elucidate other aspects related to exposure and outcomes.
Body mass index in relation to extracellular vesicle–linked microRNAs in human follicular fluid
2019, Fertility and Sterility
To study whether increased body mass index is associated with altered expression of extracellular vesicle microRNAs (EV-linked miRNAs) in human follicular fluid.
Cross-sectional study.
Tertiary-care university-affiliated center.
One hundred thirty-three women undergoing in vitro fertilization (IVF) were recruited from January 2014 to August 2016.
None.
EV-linked miRNAs were isolated from follicular fluid and their expression profiles were measured with the use of the Taqman Open Array Human miRNA panel. EV-linked miRNAs were globally normalized and inverse-normal transformed. Associations between body mass index (BMI) and EV-linked miRNA outcomes were analyzed by means of multivariate linear regression and principal component analysis.
Eighteen EV-linked miRNAs were associated with an increase in BMI after adjusting for age, ethnicity, smoking status, and batch effects. Hsa-miR-328 remained significant after false discovery rate adjustments. Principal component analyses identified the first principal component to account for 40% of the variation in our EV-linked miRNA dataset, and adjusted linear regression found that the first principal component was significantly associated with BMI after multiple testing adjustments. Using Kyoto Encyclopedia of Genes and Genomes enrichment analyses, we predicted gene targets of EV-linked miRNA in silico and identified PI3K-Akt signaling, ECM-receptor interaction, focal adhesion, FoxO signaling, and oocyte meiosis pathways.
These results show that a 1-unit increase in BMI is associated with altered follicular fluid expression of EV-linked miRNAs that may influence follicular and oocyte developmental pathways. Our findings provide potential insight into a mechanistic explanation for the reduced fertility rates associated with increased BMI.
Relación entre el índice de masa corporal y los microRNAs ligados a vesículas extracelulares del líquido folicular humano
Estudiar si un aumento en el índice de masa corporal (IMC) está asociado con una expresión alterada de los microRNAs asociados a vesículas extracelulares (EVlinked miRNAs) en el líquido folicular humano.
Estudio transversal.
Centro universitario de atención terciaria.
Se reclutaron 133 mujeres sometidas a un ciclo de fecundación in vitro (FIV) entre enero de 2014 y agosto de 2016.
Ninguna.
Se aislaron los EV-linked miRNAs del líquido folicular y se midió su perfil de expresión mediante el uso de un panel Taqman Open Array Human miRNA. Los EV-linked miRNAs fueron globalmente normalizados y transformados de forma inversamente-normal. La relación entre el índice de masa corporal (IMC) y el resultado de los EV-linked miRNA se analizó mediante regresión lineal multivariante y análisis de componentes principales.
Tras hacer un ajuste por edad, etnia, hábito de fumar y lotes, se observó una relación entre 18 EV-linked miRNAs y un aumento del IMC. Los Hsa-miR-328 permanecieron significativos tras los ajustes de hallazgos falsos. El análisis de componentes principales identificó el principal componente responsable de una variación del 40% en nuestro conjunto de datos de EV-linked miRNA, y ajustando mediante regresión lineal se encontró que el componente principal estaba asociado con el IMC, tras ajustes de pruebas múltiples. Utilizando la enciclopedia Kyoto de genes y análisis enriquecido del genoma, predijimos genes dianas de EV-linked miRN in silico e identificamos la señalización de PI3K-Akt, la interacción con el receptor matriz extracelular (ECM), la adhesión focal, la señalización Fox0 y los circuitos de la meiosis ovocitaria.
Estos resultados demuestran que el aumento de 1 unidad en el IMC está asociado con la expresión alterada de EV-linked miRNAs en el líquido, el cual puede influir en vías implicadas en el desarrollo folicular y ovocitario. Nuestros hallazgos proporcionan una percepción potencial sobre una explicación mecánica de la reducción de la fertilidad asociada a un elevado IMC.
The Effect of Obesity on Reproductive Health
2017, Practical Guide to Obesity Medicine
Obesity exerts an adverse effect on both male and female reproductive health. In both sexes obesity can lead to a dysregulation of the hypothalamic–pituitary–gonadal axis with a detrimental effect on the hormonal control of gametogenesis. In the obese male, abnormal spermatogenesis could potentially lead to abnormalities in semen parameters and sperm function. Obesity-related effects on sperm genetic integrity may contribute to a potential transgenerational epigenetic inheritance with consequent impact on the development of offspring. Female obesity is associated with reduced frequency of ovulation and also with detrimental effects on oocyte quality, endometrial development, and implantation. The net result of these changes is that there is an increased time to conception if either partner is obese. Unfortunately, there is also increasing evidence that obesity is associated with a negative impact on the success rates of assisted reproductive treatments and also an increased risk of early pregnancy failure. Weight loss through lifestyle modification, or medical or surgical treatment may improve the chance of successful spontaneous or assisted conception. Further studies are required to increase the understanding of how obesity affects human fertility and the adverse effect of obesity on assisted conception.
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: Declaration: The authors report no financial or commercial conflicts of interest.

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ArticleImpact of body mass index on IVF and ICSI outcome: a retrospective study

Abstract

Section snippets

Reproductive BioMedicine Online

Fertility and Sterility

Reproductive BioMedicine Online

Fertility and Sterility

Fertility and Sterility

Reproductive BioMedicine Online

Fertility and Sterility

Fertility and Sterility

American Journal Obstetrics and Gynecology

Classification of endometriosis

Fertility and Sterility

Anthropometric indicators and response to gonadotrophin for ovulation induction

Human Reproduction

Impact of overweight and underweight on assisted reproduction treatment

Human Reproduction

Article
Impact of body mass index on IVF and ICSI outcome: a retrospective study