Abstract
BackgroundWhether female BMI impacts the DNA repair ability in the oocytes after fertilization has not been investigated. The aim of this study is to assess the early embryo quality and reproductive outcomes of oocytes from overweight women when fertilized with sperm with varying degrees of DNA fragmentation.MethodsA total number of 1,612 patients undergoing fresh autologous in vitro fertilization (IVF) cycles was included. These patients were divided into two groups according to maternal body mass index (BMI): normal weight group (18.5–24.9 kg/m2; n=1187; 73.64%) and overweight group (≥25 kg/m2; n=425; 26.36%). Each group was then subdivided into two groups by sperm DNA fragmentation index (DFI): low fragmentation group (<20% DFI, LF) and high fragmentation group (≥20% DFI, HF). Laboratory and clinical outcomes were compared between subgroups.ResultsFor the normal-weight group, there was no statistical significance in embryo quality and reproductive outcomes between the LF and HF groups. But in the overweight group, significantly lower fertilization rate (LF: 64%; HF: 59%; p=0.011), blastocyst development rate (LF: 57%; HF: 44%; p=0.001), as well as high-quality blastocyst rate (LF: 32%; HF: 22%; p=0.034) were found in the HF group, despite the similar pregnancy rates (LF: 56%; HF: 60%; p=0.630).ConclusionsDecreased DNA repair activity in oocytes may be a possible mechanism for the low early development potential of embryos from overweight patients in in vitro fertilization cycles.
Highlights
A wide range of disorders were associated with obesity, including chronic low-grade inflammation, metabolic syndrome, diabetes, cardiovascular disease, and infertility [1,2,3,4]
Each group was subdivided into two subgroups using the sperm DNA fragmentation index (DFI): low fragmentation group (
There was no statistical difference in maternal age and anti-Müllerian hormone (AMH) level between the two body mass index (BMI) groups
Summary
A wide range of disorders were associated with obesity, including chronic low-grade inflammation, metabolic syndrome, diabetes, cardiovascular disease, and infertility [1,2,3,4]. Recent retrospective population studies have found that obese patients have poor endometrial receptivity [5], poor embryo quality [6, 7], low oocyte maturation rates [8], and subsequently, low pregnancy rate [9, 10] and high abortion rate [11, 12]. Animal experiments have shown that both gene mutation-induced obesity and high-fat diet (HFD) induced obesity could induce reactive oxygen species (ROS), disrupt meiotic maturation, and affect DNA and histone methylation, as well as decrease DNA repair activity (DRA) in oocytes [13, 14]. Whether female BMI impacts the DNA repair ability in the oocytes after fertilization has not been investigated. The aim of this study is to assess the early embryo quality and reproductive outcomes of oocytes from overweight women when fertilized with sperm with varying degrees of DNA fragmentation
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