Impact of BMI on cumulative birth rate in patients with normal ovarian response
Objective To compare the effects of different body mass index(BMI)on the cumulative birth rate(CLBR)in patients with normal ovarian response undergoing in vitro fertilization/intracytoplasmic sperm microinjection(IVF/ICSI).Methods A retrospective analysis of 3,227 oocyte retrieval cycles treated with IVF/ICSI was performed.Patients were divided into low BMI group(BMI＜18.5,n=167),normal BMI group(18.5≤BMI＜24.0,n=2,024),overweight group(24.0≤BMI＜28.0,n=816),and obese group(BMI≥28.0,n=220).Clinical characteristics,labo-ratory indicators and pregnancy outcomes were compared among the groups.Results The total amount of gonadotro-phin(Gn)elevated with increasing BMI in all four groups,with significant difference(P＜0.001).There were no sig-nificant differences in the number of oocytes,number of high-quality embryos,2PN fertilization rate,and 2PN cleavage rate among the four groups(P＞0.05).The high-quality embryo rate and blastocyst formation rate in the obese group were lower than those in the normal BMI group(P=0.012,P＜0.001)and overweight group(P=0.014,P＜0.001).Oocyte utilization was significantly lower in the overweight and obese groups than in the normal BMI group(P=0.031,P=0.002).The miscarriage rate was higher in the overweight group than in the normal BMI group(P=0.013).CLBR was lower in the obese and overweight groups than in the normal BMI group(P=0.009,P=0.023).There were no sig-nificant differences in the clinical pregnancy rate and preterm labor rate among the four groups(P＞0.05).Higher BMI was significantly associated with lower CLBR,and an adjusted OR(95％CI)was 0.953(0.948-0.958).Conclusion In patients with normal ovarian response undergoing assisted reproductive technology,overweight and obesity lead to in-creased total dosage of Gn,and the high-quality embryo rate,blastocyst formation rate,oocyte utilization rate and CLBR are significantly lower in obese patients,indicating that such patients should undergo aggressive weight loss be-fore proceeding to assisted reproduction therapy.
Body mass indexCumulative birth rateIn vitro fertilization-embryo transferObesity
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