Original article
Body mass index and short-term weight change in relation to treatment outcomes in women undergoing assisted reproduction

Preliminary results of this study were presented in part at the 65th Annual Meeting of the American Society for Reproductive Medicine, October 23-27, 2010, Denver, Colorado.
https://doi.org/10.1016/j.fertnstert.2012.04.012Get rights and content

Objective

To assess the relation between body mass index (BMI) and short-term weight change with assisted reproductive technology (ART) outcomes.

Setting

Fertility center.

Patient(s)

A total of 170 women undergoing 233 ART cycles.

Intervention(s)

Baseline BMI and short-term weight change were related to ART outcomes. Regression models accounting for repeated observations were used to adjust data for potential confounders.

Main Outcome Measure(s)

Peak E2 levels, oocyte yield, MII yield, fertilization rate, embryo quality, postive [beta]-hCH, clinical pregnancy and live birth rates.

Result(s)

Overweight and obesity were associated with lower live birth rates. The adjusted live birth rate (95% confidence interval) was 42% (28%–58%) among women with a BMI between 20 and 22.4 kg/m2 and 23% (14%–36%) among overweight or obese women. Short-term weight loss was associated with a higher proportion of metaphase II (MII) oocytes retrieved. The adjusted proportion of MII eggs was 91% (87%–94%) for women who lost 3 kg or more and 86% (81%–89%) for women whose weight remained stable. This association was stronger among women who were overweight or obese at baseline. Short-term weight loss was unrelated to positive β-hCG, clinical pregnancy, or live birth rates.

Conclusion(s)

Overweight and obesity were related to lower live birth rates in women undergoing ART. Short-term weight loss was related to higher MII yield, particularly among overweight and obese women, but unrelated to clinical outcomes.

Section snippets

Study Population

Participants were women enrolled in the EARTH Study, an ongoing prospective cohort started in 2004 aimed at identifying environmental and nutritional determinants of fertility among couples presenting for infertility evaluation and treatment at the Massachusetts General Hospital Fertility Center. Women and men aged between 18 and 45 years using their own gametes for IUI or IVF were eligible to enroll in the study. Enrollment as a couple is not required for participation. Upon entry, all

Results

There were 170 women who collectively underwent 233 IVF/ICSI cycles with complete anthropometric and clinical data available for analyses. Women were primarily Caucasian (86%), had never smoked (72%), and had a mean (SD) age of 35.4 (3.9) years. The mean (SD) BMI at study enrollment was 24.5 (4.7) kg/m2, with 35% of women being overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥30 kg/m2). The average time between study enrollment and the anthropometric evaluation preceding their first ART cycle was

Discussion

We examined the associations of BMI and short-term weight change with embryologic and clinical outcomes in a contemporary cohort of women undergoing infertility treatment with ART. As expected, BMI was associated with reduced peak E2 levels and live birth rates. Losing weight before initiation of ART was related to higher yield of MII oocytes, particularly among women who were overweight or obese at baseline. Short-term weight change, however, was not related to clinical outcomes among women

Acknowledgments

The authors thank the study participants and research nurses Jennifer Ford, B.S.N., R.N., and Myra Keller, B.S.N., R.N., for their contributions.

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    J.E.C. has nothing to disclose. S.E. has nothing to disclose. D.S.C. has nothing to disclose. D.L.W. has nothing to disclose. T.L.T. has nothing to disclose. J.C.P. has nothing to disclose. R.H. has nothing to disclose.

    This work was supported by grants ES009718 and ES000002 from the National Institute of Environmental Health Sciences and DK46200 from the National Institute of Diabetes and Digestive and Kidney Diseases.

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