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High BMI and IVF

Should high BMI be a reason for IVF treatment denial?

, , , , &
Pages 853-856
Received 28 Nov 2016
Accepted 02 May 2017
Published online: 20 May 2017

Abstract

Our aim was to examine the influence of BMI on the live-birth rate following IVF/ICSI and evaluate its specific contribution among other factors thus enabling accurate reproductive policy development. All patients that underwent IVF/ICSI at our center during January 2012–July 2015 were included in this retrospective study. A total of 1654 ICSI cycles were divided into four groups according to the patient’s BMI (kg/m2): group I (normal weight): <25 (943 cycles); group II (overweight): 25–30 (403 cycles); group III (obese): 30–35 (212 cycles); group IV (morbid obesity): >35 (96 cycles). Comparing the four groups of BMI, mean age and number of previous ART cycles was significantly lower in group I compared to groups II, III and IV. Length of treatment was significantly shorter in group I compared to groups II, III and IV. Ovarian response to COH was comparable in terms of mean estradiol and progesterone levels on the day of hCG administration mean number of oocytes retrieved, fertilized and number of embryos transferred. Endometrial thickness was significantly lower in group IV. Outcome measures, such as implantation rate, clinical pregnancy rate (CPR) per cycle and per ET, as well as live-birth rates did not differ significantly between the groups, although in group IV LBR per cycle and per ET was lower. Multivariate logistic regression stepwise analysis found a significant correlation between age and BMI but did not find correlation between BMI and clinical pregnancy (p = 0.436) or LB (p = 0.206). The results of our relatively large retrospective study did not demonstrate a significant impact of BMI on the ART cycle outcome. Therefore, BMI should not be a basis for IVF treatment denial.

Chinese abstract

本研究目的是研究BMI对IVF/ICSI后活产率的影响, 并评估其在其他影响因素中的作用, 从而制定准确的生殖发展方案。该回顾性研究招募了2012年1月至2015年7月所有在本中心实施IVF/ICSI的病人。根据病人的BMI(kg/m2)将1654个ICSI周期分成4组:I组(正常体重):<25 (943个周期);II组(超重):25-30(403个周期);III组(肥胖):30-35(212个周期);IV组(病态性肥胖):>35(96个周期)。比较BMI不同的四组, I组的平均年龄及以前的ART周期数显著少于II, III, IV组。根据hCG日平均雌二醇和孕酮水平, 平均卵母细胞获取数、受精数和移植胚胎数, 卵巢对COH的反应性是可比的。IV组的内膜厚度显著降低。结果评价, 如植入率、每周期临床妊娠率(CPR)和胚胎移植率, 以及活产率在四组间无统计学差异, 尽管IV组的每周期活产率和胚胎移植率略低。

多元logistic逐步回归分析发现年龄与BMI间有较强的关联, 但未发现BMI与临床妊娠率(p = 0.436)或活产(p = 0.206)之间有关联。我们相对大样本的回顾性研究结果并未证实BMI对ART周期结局的显著影响。因此, BMI不应作为拒绝IVF的基础。

Disclosure of interest

The authors report no conflicts of interest.

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