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The effect of female body mass index on in vitro fertilization cycle outcomes: a multi-center analysis

  • Assisted Reproduction Technologies
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Abstract

Purpose

The aim of this study is to examine the impact of female body mass index (BMI) on IVF cycle outcomes.

Methods

This is a retrospective cohort study including 51,198 women who initiated their first autologous IVF cycle in 13 fertility centers in the USA between 2009 and 2015. The effect of underweight, overweight, and obese BMI on four different IVF cycle outcomes (cycle cancellation, oocyte and embryo counts, and ongoing clinical pregnancy [OCP]) was evaluated in logistic or Poisson regression analyses with confounders adjusted.

Results

Women with an overweight or obese BMI experienced worse outcomes than those with a normal BMI. These differences included (1) greater odds of cycle cancellation (aOR [95%CI] 1.17 [1.08, 1.26] for overweight, 1.28 [1.15, 1.41] for class-I obesity, and 1.50 [1.33, 1.68] for class-II/III obesity, P < .001 for all); (2) fewer oocytes retrieved (aIRR [95%CI] 0.98 [0.98,0.99] for class-I obesity, 0.93 [0.92,0.94] for class-II/III obesity, P < .001 for both); (3) fewer usable embryos (aIRR [95%CI] 0.98 [0.97,0.99] for overweight, 0.97 [0.96,0.99] for class-I obesity, 0.95 [0.93,0.97] for class-II/III obesity, P < .01 for all); and (4) lower odds of OCP (aOR [95%CI] 0.89 [0.83,0.95] for class-I obesity, 0.86 [0.79,0.93] for class-II/III obesity, P < .001 for both). In a subgroup analysis based on primary infertility diagnosis, these trends persisted in those with male or uterine factor and were especially pronounced in women with ovulatory dysfunction or PCOS.

Conclusions

A BMI above the normal range was an independent negative prognostic factor for multiple outcomes, including cycle cancellation, oocyte and embryo counts, and OCP. These negative outcomes were most profound in women with class-II/III obesity, ovulatory dysfunction, or PCOS.

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Acknowledgements

We would like to thank all of the centers in the Polaris Data Network who contributed data to this study including the following (listed alphabetically): Center for Advanced Reproductive Services, Hartford, CT, USA; Coastal Fertility Specialists, Mount Pleasant, SC, USA; Fertility Centers of Illinois, Highland Park, IL, USA; IVF Florida Reproductive Associates, Miami, FL, USA; Reproductive Endocrinology Associates of Charlotte, Charlotte, NC, USA; Reproductive Medicine Associates of Connecticut, Stamford, CT, USA; Reproductive Medicine Associates of Michigan, Troy, MI, USA; Reproductive Medicine Associates of New York, New York, NY, USA; Reproductive Medicine Associates of Philadelphia, Philadelphia, PA, USA; Reproductive Medicine Associates of Texas, San Antonio, TX, USA; Reproductive Science Center of the San Francisco Bay Area, San Ramon, CA, USA; Seattle Reproductive Medicine, Seattle, WA, USA; Shady Grove Fertility, Rockville, MD, USA.

Funding

This study was sponsored by Celmatix Inc.

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Correspondence to Piraye Yurttas Beim.

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Conflict of interest

A.B.C. is an advisor for Celmatix and board member for Sema4 Genomics. P.Y.B. has a patent pending (US62460415). The other coauthors declare no conflict of interest.

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Kudesia, R., Wu, H., Hunter Cohn, K. et al. The effect of female body mass index on in vitro fertilization cycle outcomes: a multi-center analysis. J Assist Reprod Genet 35, 2013–2023 (2018). https://doi.org/10.1007/s10815-018-1290-6

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