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A non-linear dose-response relation of female body mass index and in vitro fertilization outcomes

  • Assisted Reproduction Technologies
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Abstract

Purpose

Obesity, measured by body mass index (BMI), is implicated in adverse pregnancy outcomes for women seeking in vitro fertilization (IVF) care. However, the shape of the dose-response relationship between BMI and IVF outcomes remains unclear.

Methods

We therefore conducted a dose-response meta-analysis using a random effects model to estimate summary relative risk (RR) for clinical pregnancy (CPR), live birth (LBR), and miscarriage risk (MR) after IVF.

Results

A total of 18 cohort-based studies involving 975,889 cycles were included. For each 5-unit increase in BMI, the summary RR was 0.95 (95% CI: 0.94–0.97) for CPR, 0.93 (95% CI: 0.92-0.95) for LBR, and 1.09 (95% CI: 1.05-1.12) for MR. There was evidence of a non-linear association between BMI and CPR (Pnon-linearity < 10−5) with CPR decreasing sharply among obese women (BMI > 30). Non-linear dose-response meta-analysis showed a relatively flat curve over a broad range of BMI from 16 to 30 for LBR (Pnon-linearity = 0.0009). In addition, we observed a J-shaped association between BMI and MR (Pnon-linearity = 0.006) with the lowest miscarriage risk observed with a BMI of 22–25.

Conclusions

In conclusion, obesity contributed to increased risk of adverse IVF outcomes in a non-linear dose-response manner. More prospective trials in evaluating the effect of body weight control are necessary.

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Data availability

Data analyzed in this study are openly available at locations cited in the reference section.

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Acknowledgements

We thank Dr. Gitte Lindved Petersen and Dr. Veronica Sarais for making their data available for the present study.

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Correspondence to Kefu Tang.

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Tang, K., Guo, Y., Wu, L. et al. A non-linear dose-response relation of female body mass index and in vitro fertilization outcomes. J Assist Reprod Genet 38, 931–939 (2021). https://doi.org/10.1007/s10815-021-02082-8

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  • DOI: https://doi.org/10.1007/s10815-021-02082-8

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