Abstract
Objective To examine the association between body mass index (BMI) and the outcome of in vitro fertilization or intracytoplasmic sperm injection embryo transfer- (IVF/ICSI-ET) assisted reproduction in women with polycystic ovary syndrome (PCOS) receiving the ultra-long agonist protocol. Methods We retrospectively identified all women receiving IVF/ICSI-ET for the first time using the ultra-long protocol between January 2013 and January 2018 at our hospital. Only women at ≤35 years of age receiving the first cycle were analyzed. Results A total of 1782 women were included in the analysis: 42 were underweight, 742 were overweight, 198 were obese, and 800 were normal weight. Gonadotropin dosage and duration were comparable between underweight and normal weight groups but were significantly higher/longer in overweight and obese groups (P < 0.008). The number of oocytes retrieved was significantly lower in overweight and obese groups than in the normal weight group (P < 0.008). The number of transferable embryos was significantly higher in normal weight group than overweight and obese groups (P < 0.008). Embryo implantation rate, clinical pregnancy rate, full-term birth rate, and live birth rate did not differ among the 4 groups. The cycle cancellation rate was lower in the overweight and obese group than normal weight group (P < 0.008). The miscarriage rate was higher in the obese group than the normal weight group (P < 0.008). In multivariate logistic regression analysis, abnormal BMI was an independent risk for miscarriage (OR: 1.069, 95% CI 1.020, 1.122; P = 0.006). Conclusion Overweight and obesity are associated with poor outcomes in PCOS patients receiving ultra-long protocol. Measures to reduce body weight should be encouraged in overweight and obese PCOS women at ≤35 years of age prior to assisted reproductive technology (ART).
Highlights
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age [1, 2]
We examined the potential association between body mass index (BMI) with reproductive outcomes in PCOS women receiving ultra-long protocol for IVF/ICSI-ET
Many studies are available on the effects of obesity on the therapeutic outcome of IVF/ICSI in PCOS women, but they often have a limited sample size
Summary
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age [1, 2]. 80%-95% of women with anovulatory infertility have PCOS [3, 4]. Overweight and obesity are increasingly common in the general population as well as in women of reproductive age. Estimated age-standardized prevalence in women is 14.9% (13.6%-16.1%) for obesity (BMI ≥ 30 kg/m2), 5.0% (4.4%-5.6%) for severe obesity (BMI ≥ 35 kg/m2), and 1.6% (1.3%-1.9%) for morbid obesity (BMI ≥ 40 kg/m2) [5]. Obesity has been associated with adverse obstetric outcome [6]. In China, approximately one-third of PCOS women have a BMI higher than 23 kg/m2 [10]. Obesity has been associated with adverse reproductive outcomes in Chinese women with PCOS [11]
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