Does body mass index compromise assisted reproductive technique outcomes? A cross-sectional study

Bahrami F, Fereshteh Bahrami, Saeideh Dashti, Dashti S, Mangoli E, Esmat Mangoli, Hanie Sadat Hosseini, Sadat Hosseini H
International journal of reproductive biomedicine · 2023 · vol. 21(12) , pp. 1021–1030 · doi:10.18502/ijrm.v21i12.15040 · PMID:38370492 · PMC10869964
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This cross-sectional study of 1611 women undergoing assisted reproductive technology found that body mass index categories did not significantly affect live birth rates, although metabolic and ovarian response parameters varied significantly across groups.

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This cross-sectional study analyzed ART outcomes in 1611 Iranian women to determine if body mass index compromises live birth rates, implantation, or pregnancy success. The researchers found that while obese patients required significantly higher doses of gonadotropins and underweight patients had fewer mature oocytes, these factors did not result in statistically significant differences in live birth, implantation, or abortion rates across the four BMI categories. Subgroup analyses confirmed that age and specific causes of infertility, such as polycystic ovary syndrome, did not alter the lack of association between BMI and successful ART outcomes. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

BACKGROUND: Overweight and obese people face several health problems. Female obesity has been shown to reduce fertility in the general population. Assisted reproductive technology outcomes in obese cases are widely studied, but the results are inconclusive. OBJECTIVE: This study aimed to compare live birth rate (LBR) among women with 4 different types of body mass index (BMI). MATERIALS AND METHODS: In this cross-sectional study, data of 1611 women, who were candidates for fresh and frozen embryo transfer cycles, was extracted from 2051 medical files at the Reproductive Sciences Institute, Yazd, Iran from May 2019-May 2021. The participants were divided into 4 groups (underweight, normal, overweight, and obese) according to their BMI, and LBR was considered to be the main outcome. RESULTS: Of 1611 women, 39 were underweight, 585 were normal, 676 were overweight, and 311 were obese. Underweight women had the lowest LBR (12.8%), but there was no statistically significant difference (p = 0.55). In addition, LBR was compared in the 4 BMI groups according to age, type of transfer cycle (fresh or freeze), and cause of infertility, and there was comparable LBR in the 4 BMI groups. However, metaphase 2 oocyte rate, doses of gonadotropin usage in the cycles, and estradiol level had statistically significant differences (p < 0.001). CONCLUSION: According to our study, obesity does not affect LBR in the IVF cycle, regardless of fresh or frozen embryo transfer cycles, different age groups, and causes of infertility.
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According to our findings and some similar studies, BMI may not be a prognostic factor for ART outcomes. Factors such as age, antral follicular count, and AMH are the best prognostic factors. It is recommended to conduct a multi-center prospective study with a larger sample size and the impact of some factors like lifestyle, previous ART cycles, or comorbidity.

Coi Statement

The authors declare that there is no conflict of interest.

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