Elevated body mass index in modified natural cycle frozen euploid embryo transfers is not associated with live birth rate.

Beshar I, Milki AA, Amin A. Milki, Rebecca M. Gardner, Gardner RM, Wendy Y. Zhang, Johal JK, Jasmyn K. Johal, Brindha Bavan, Bavan B
Journal of assisted reproduction and genetics · 2023 · doi:10.1007/s10815-023-02787-y · PMID:37000344 · PMC10239415
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This retrospective study found that elevated body mass index is not associated with reduced live birth or clinical pregnancy rates following modified natural cycle frozen embryo transfers of euploid embryos.

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Abstract

PurposeTo assess the impact of elevated BMI on the success of modified natural cycle frozen embryo transfers (mNC-FET) of euploid embryos.MethodsThis retrospective cohort study at a single academic institution reviewed mNC-FET involving single euploid blastocysts from 2016 to 2020. Comparison groups were divided by pre-pregnancy BMI (kg/m2) category: normal weight (18.5-24.9), overweight (25-29.9) or obese (≥ 30). Underweight BMI (< 18.5) was excluded from the analysis. The primary outcome was live birth rate (LBR) and secondary outcome was clinical pregnancy rate (CPR), defined as presence of fetal cardiac activity on ultrasound. Absolute standardized differences (ASD) were calculated to compare descriptive variables and p-values and multivariable logistic regressions with generalized estimating equations (GEE) were used to compare pregnancy outcomes.Results562 mNC-FET cycles were completed in 425 patients over the study period. Overall, there were 316 transfers performed in normal weight patients, 165 in overweight patients, and 81 in obese weight patients. There was no statistically significant difference in LBR across all BMI categories (55.4% normal weight, 61.2% overweight, and 64.2% obese). There was also no difference for the secondary outcome, CPR, across all categories (58.5%, 65.5%, and 66.7%, respectively). This was confirmed in GEE analysis when adjusting for confounders.ConclusionWhile increased weight has commonly been implicated in poor pregnancy outcomes, the effect of BMI on the success of mNC-FET remains debated. Across five years of data from a single institution using euploid embryos in mNC-FET cycles, elevated BMI was not associated with reduced LBR or CPR.

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[{'doi': '10.13039/501100000850', 'name': 'National Heart and Lung Institute', 'awards': ['Grant Number 1T32HL151323']}]

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