Abstract
Purpose
To evaluate the association between body mass index (BMI) and pregnancy outcomes in women receiving intrauterine insemination (IUI) treatment.
Methods
The study included 6407 women undergoing 13,745 IUI cycles stratified by BMI. Cox regression was used to analyze the association between BMI and cumulative live births across multiple IUI cycles. A generalized estimating equation (GEE) was used to analyze the live birth rate per cycle.
Results
Compared with normal-weight women (n = 4563), underweight women (n = 990) had a lower cumulative pregnancy and live birth rate (20.71% vs 25.93% and17.17% vs 21.61%, respectively), while overweight women (n = 854) had a higher cumulative pregnancy and live birth rate (31.97%, 26.58%). Adjusted for confounders, the hazard ratio (HR) for achieving live birth following up to a maximum of four IUI cycles was 0.80 (95% CI: 0.67–0.95), comparing underweight with normal weight. In the GEE analyses, low BMI was also associated with a lower per-cycle birth rate (OR 0.79, 95% CI: 0.66–0.95), with adjustment for cycle-specific parameters, including ovarian stimulation, endometrial thickness, and follicular diameter.
Conclusion
Low BMI is associated with poor IUI outcomes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cohlen B, Bijkerk A, Van der Poel S, Ombelet W. IUI: review and systematic assessment of the evidence that supports global recommendations. Hum Reprod Update. 2018;24(3):300–19.
Fertility problems: assessment and treatment. London: © Nice 2020.; 2017 Sep.
Tjon-Kon-Fat RI, Bensdorp AJ, Bossuyt PM, Koks C, Oosterhuis GJ, Hoek A, et al. Is IVF-served two different ways-more cost-effective than IUI with controlled ovarian hyperstimulation? Hum Reprod. 2015;30(10):2331–9.
De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, et al ART in Europe, 2015: results generated from European registries by ESHRE. 2020;2020(1):038.
Zhou Z, Chen L, Wu H, Zheng D, Li R, Mol BW, et al. Assisted reproductive technology in Beijing, 2013–2015. Reprod Biomed Online. 2018;37(5):521–32.
Sermondade N, Huberlant S, Bourhis-Lefebvre V, Arbo E, Gallot V, Colombani M, et al. Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis. Hum Reprod Update. 2019;25(4):439–51.
Whynott RM, Summers KM, Van Voorhis BJ, Mejia RB. Effect of body mass index on intrauterine insemination cycle success. Fertil Steril. 2021;115(1):221–8.
Aydin Y, Hassa H, Oge T, Tokgoz VY. Factors predictive of clinical pregnancy in the first intrauterine insemination cycle of 306 couples with favourable female patient characteristics. Hum Fertil (Camb). 2013;16(4):286–90.
Isa AM, Abu-Rafea B, Alasiri SA, Binsaleh S, Ismail KH, Vilos GA. Age, body mass index, and number of previous trials: are they prognosticators of intra-uterine-insemination for infertility treatment? Int J Fertil Steril. 2014;8(3):255–60.
Huyghe S, Verest A, Thijssen A, Ombelet W. Influence of BMI and smoking on IUI outcome with partner and donor sperm. Facts Views Vis Obgyn. 2017;9(2):93–100.
Wang JX, Warnes GW, Davies MJ, Norman RJ. Overweight infertile patients have a higher fecundity than normal-weight women undergoing controlled ovarian hyperstimulation with intrauterine insemination. Fertil Steril. 2004;81(6):1710–2.
McKnight KK, Nodler JL, Cooper JJ Jr, Chapman VR, Cliver SP, Bates GW Jr. Body mass index-associated differences in response to ovulation induction with letrozole. Fertil Steril. 2011;96(5):1206–8.
Malizia BA, Hacker MR, Penzias AS. Cumulative live-birth rates after in vitro fertilization. N Engl J Med. 2009;360(3):236–43.
Souter I, Baltagi LM, Kuleta D, Meeker JD, Petrozza JC. Women, weight, and fertility: the effect of body mass index on the outcome of superovulation/intrauterine insemination cycles. Fertil Steril. 2011;95(3):1042–7.
Immediata V, Patrizio P, Parisen Toldin MR, Morenghi E, Ronchetti C, Cirillo F, et al. Twenty-one year experience with intrauterine inseminations after controlled ovarian stimulation with gonadotropins: maternal age is the only prognostic factor for success. J Assist Reprod Genet. 2020;37(5):1195–201.
Na L, Chen Y, Zhai H, Liao A, Huang D. Effects of maternal body mass index on pregnancy outcome after 8570 artificial insemination cycles with donor’s sperm. Gynecol Endocrinol. 2018;34(12):1068–72.
Wang LT, Wang CX, Sun HL, Wang X, Li XF, Wang YL, et al. Effect of BMI on blood value of patients on HCG day with IUI treatment. BMC Womens Health. 2020;20(1):105.
Acknowledgements
The authors thank all of the staff, nurses, and physicians at the Reproductive Medicine Center for their support in generating this manuscript.
Funding
This work was funded by the Clinical Research Special Fund of Chinese Medical Association (NO.18010360765), Xiamen Medical Advantage Subspecialty Construction Project (2018296) and Xiamen Medical and Health Guidance Project (3502Z20214ZD1189).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zheng, J., Cai, J., Liu, L. et al. Low BMI is associated with poor IUI outcomes: a retrospective study in 13,745 cycles. J Assist Reprod Genet 39, 2819–2825 (2022). https://doi.org/10.1007/s10815-022-02658-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10815-022-02658-y