Abstract
Objective: To investigate the cumulative live birth rates (CLBR) according to body mass index (BMI) in women undergoing their first in vitro fertilization (IVF).Design: Retrospective cohort analysis.Setting: An IVF clinic in a public hospital.Patients: This is a retrospective study of 14,782 patients undergoing their first fresh IVF cycles and subsequent frozen embryo transfers in our clinic from January 2014 to January 2017. The follow-up for CLBR continued until January 2019. Patients with a BMI <18.5 kg/m2 were considered to be underweight and those with a BMI > 24 kg/m2 were considered to be overweight. Patients with a BMI ≥ 28 kg/m2 were considered to be obese.Intervention(s): None.Primary Outcome Measure: The primary outcome was cumulative live birth rate (CLBR).Result(s): This study illustrated the “inverted U shape” associations between body weight and IVF outcome (CLBR). The turning points in threshold analysis, as found by an automatic search, were BMIs of 18.5 and 30.4 kg/m2. The main finding of this retrospective data analysis is that the CLBR increased in underweight women, plateaued for normal weight and overweight women with a BMI between 18.5 and 30.4 kg/m2, and decreased in obese women.Conclusion(s): The data suggested an “inverted U shape” association between BMI and CLBR. The CLBR increases in underweight women, plateaus in normal weight and overweight women, and then decreases in obese women.
Highlights
Numerous studies have shown that a body mass index (BMI) that is either too high or too low is associated with a reduced probability of achieving pregnancy in women undergoing assisted reproductive technology (ART) [1]
The main finding of this retrospective data analysis is that the cumulative live birth rate (CLBR) increased among underweight women, plateaued in normal weight and overweight women, and decreased in obese women
While obesity has been demonstrated to impair pregnancy outcome, more issues focus on underweight and overweight women (24–28 kg/m2)
Summary
Numerous studies have shown that a body mass index (BMI) that is either too high or too low is associated with a reduced probability of achieving pregnancy in women undergoing assisted reproductive technology (ART) [1] Most of these studies are limited by being cycle-based [2,3,4,5], in which they only studied fresh cycles and reported the outcome in terms of live births per fresh cycle or embryo transfer. In addition to affecting other aspects of the body’s functions [6], BMI has an impact on the female reproductive system, both pre- and post-pregnancy In this respect, a patient-based cumulative live birth rate (CLBR) that includes all fresh and frozen embryo transfers is a more suitable and more comprehensive measurement when reporting outcomes of ART [7].
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