Correlation between body mass index (BMI) and serum beta hCG levels post hCG with ART cycle outcomes

Abstract

OBJECTIVE: To evaluate if 250 mcg rhCG in women with different BMIs achieved similar serum beta hCG levels for follicular maturation and successful ART outcomes.DESIGN: Retrospective study.MATERIALS AND METHODS: 84 consecutive ART cycles between January - March 2008 were included. Women were treated with GnRH agonist/antagnosists, stimulation began with 150-450 IU rhFSH and 75-150 IU rhLH or hMG added day 6 or 7. Response was assessed by ultrasound after 5 days of treatment; the dose of rhFSH ± rhLH/hMG adjusted as needed. Final follicular maturation was with 250 mcg r-hCG; serum beta hCG levels were measured 12-14 hrs later. Retrieval was done 36-37 hrs post hCG injection. ET was on day 5 or 6. Patients were stratified according to their BMI (kg/m2): 16-20, 21-25, 26-28, and 29-36. Statistical analysis: ANOVA test for continuous data and X2 for categorical data; significance: p<0.05.Table 1Body Mass Index (BMI (kg/m2)16-2021-2526-2829-36P valueN cycles13461411Age (yrs)32.1±4.733.5±4.637.0±3.4∗34.1±4.0∗0.02BMI19.3±1.222.8±1.327.0±0.931.1±2.2<0.001days of stim9.2±3.49.3±1.49.5±1.29.9±1.50.78Total 75 IU FSH24.0±13.832.4±13.034.6±15.341.8±17.2∗∗0.04Total 75 IU LH5.6±1.95.9±3.55.5±3.75.1±2.90.91#foll > 15 mm11.6±7.09.0±4.98.1±4.58.2±3.40.27Peak E2pg/ml2195±14402495±12952186±8321922±7860.48E2 post hCG3219±21662968±14242707±12552583±13850.74serum hCG (IU/L)135±51102±6389±4270±560.05# eggs17.4±11.613.6±6.113.6±6.711.4±4.50.21# mature oocytes15.0±11.111.3±5.712.0±6.77.8±4.30.09MII/total eggs0.810.810.840.660.05# 2PN8.3±8.06.8±4.36.5±2.54.0±2.80.77# blasts transferred1.6±1.01.2±0.81.7±0.71.1±0.80.19# blasts frozen∗∗4.6±1.63.0±2.34.0±1.71.6±0.50.24Clinical pregnancy rate (%)46.1 (6/13)43.8 (20/46)42.8 (6/14)45.4 (5/11)0.61∗ Frozen on day 6. Open table in a new tab CONCLUSIONS: Women with lower BMI (16-20 kg/m2) achieved higher serum levels of beta hCG, had more MII oocytes and blastocysts than those in the highest BMI group. Pregnancy rates were similar for all groups. Patients with a BMI >29 kg/m2 may require a higher dose of rhCG to achieve similar higher serum beta hCG levels which are associated, in women with lower BMIs, with more mature oocytes and higher blastulation rate. OBJECTIVE: To evaluate if 250 mcg rhCG in women with different BMIs achieved similar serum beta hCG levels for follicular maturation and successful ART outcomes. DESIGN: Retrospective study. MATERIALS AND METHODS: 84 consecutive ART cycles between January - March 2008 were included. Women were treated with GnRH agonist/antagnosists, stimulation began with 150-450 IU rhFSH and 75-150 IU rhLH or hMG added day 6 or 7. Response was assessed by ultrasound after 5 days of treatment; the dose of rhFSH ± rhLH/hMG adjusted as needed. Final follicular maturation was with 250 mcg r-hCG; serum beta hCG levels were measured 12-14 hrs later. Retrieval was done 36-37 hrs post hCG injection. ET was on day 5 or 6. Patients were stratified according to their BMI (kg/m2): 16-20, 21-25, 26-28, and 29-36. Statistical analysis: ANOVA test for continuous data and X2 for categorical data; significance: p<0.05. ∗ Frozen on day 6. CONCLUSIONS: Women with lower BMI (16-20 kg/m2) achieved higher serum levels of beta hCG, had more MII oocytes and blastocysts than those in the highest BMI group. Pregnancy rates were similar for all groups. Patients with a BMI >29 kg/m2 may require a higher dose of rhCG to achieve similar higher serum beta hCG levels which are associated, in women with lower BMIs, with more mature oocytes and higher blastulation rate.