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Obesity Affects Endometrial Receptivity by Displacing the Window of Implantation

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Abstract

Our aim was to determine prospectively whether increased body mass index (BMI) affects endometrial receptivity through displacement of the window of implantation (dWOI) using the endometrial receptivity analysis (ERA), and whether this effect is BMI-dependent. We recruited a population of 170 infertile women with a normal uterus and no clinical history of recurrent miscarriage or implantation failure. These women were divided into four groups according to BMI: normal weight (18.5–24.9 kg/m2; n = 44), overweight (25–29.9 kg/m2; n = 29), class I obese (30.0–34.9 kg/m2; n = 54), and class II and III obese (> 35 kg/m2; n = 43). We also assigned the patients to one of two larger BMI cohorts: non-obese (normal weight and overweight; n = 73) and obese (class I, II, and III obese; n = 97). We compared analytical and clinical data and dWOI in these categories, finding significant metabolic differences in glycemia, TSH, insulin, HDL cholesterol, LDL cholesterol, triglycerides, and systolic and diastolic blood pressure among the different BMI groups. One-day dWOI increased significantly with BMI, and significant differences were observed in the non-obese versus obese categories (9.7% vs 25.3 %, respectively (p = 0.02)). dWOI was most pronounced in patients with class II–III obesity. In addition, displacement was longer as BMI increased since ERA revealed a higher proportion of displacements of 1 day than of 12 h and showed they were predominantly pre-receptive. In conclusion, obesity has a negative effect on endometrial receptivity through delaying of the WOI, which increases in function of BMI as well as the metabolic disturbances of the patient.

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Acknowledgements

We would like to thank all the organisms, clinicians, embryologists, and nurses involved in this work, and especially Sheila Caloto Mosteirin for her tireless work in selecting candidates for the study.

Funding

Igenomix S.L

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Authors and Affiliations

  1. IVI-RMA Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain

    José Bellver, Elena Labarta, Carmina Vidal, Juan Giles, Sergio Cabanillas, Alicia Marzal & Daniela Galliano

  2. Department of Pediatrics, Obstetrics & Gynecology, University of Valencia, Valencia, Spain

    José Bellver & Carlos Simón

  3. IVI Foundation, Health Research Institute La Fe, Valencia, Spain

    José Bellver & Elena Labarta

  4. Igenomix Foundation-INCLIVA, Parque Tecnológico de Paterna, Ronda Narciso Monturiol Estarriol 11B, 46980, Paterna, Valencia, Spain

    Carlos Marín, Maria Ruiz-Alonso, Carlos Simón & Diana Valbuena

  5. Department of Obstetrics & Gynecology, REI Division, Stanford University, Stanford, CA, USA

    Ruth B. Lathi, G. Murugappan & Carlos Simón

Authors
  1. José Bellver
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  2. Carlos Marín
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  6. Carmina Vidal
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  7. Juan Giles
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  8. Sergio Cabanillas
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  9. Alicia Marzal
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  11. Maria Ruiz-Alonso
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  12. Carlos Simón
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  13. Diana Valbuena
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Jose Bellver and Carlos Marin equal contribution.

Corresponding author

Correspondence to José Bellver.

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CEIC IVI VALENCIA approved 2nd July 2014.

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Yes, Carlos Simon, Diana Valbuena, Carlos Marin, and Maria Ruiz-Alonso are employees of Igenomix.

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Bellver, J., Marín, C., Lathi, R.B. et al. Obesity Affects Endometrial Receptivity by Displacing the Window of Implantation. Reprod. Sci. 28, 3171–3180 (2021). https://doi.org/10.1007/s43032-021-00631-1

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