EFFECT OF FEMALE BODY MASS INDEX ON INTRAUTERINE INSEMINATION OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE LITERATURE

Abstract

To evaluate the evidence addressing the effect of female Body Mass Index (BMI) on intrauterine insemination (IUI) treatment outcomes. Studies examining the effect of female BMI on clinical outcomes following IUI were compared. Study characteristics and methodological quality were recorded, and relevant data extraction was performed independently, and discrepancies were resolved by consensus. Clinical outcomes of interest included clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate were compared within two cohorts (BMI < 25 kg/m2 versus BMI ⩾25 kg/m2). The data for each outcome was pooled and reported as a relative risk (RR) with 95% confidence interval (CI). The I2 statistic was used to assess heterogeneity of treatment effects between the studies. Fixed and random effects models of analysis were used based on the heterogeneity of the studies. 10 studies accounting for 16,971 cycles met the inclusion criteria for the meta-analysis. 9417 cycle in the normal BMI (<25) were compared to 7554 cycles in the raised BMI category (≥25). The LBR was significantly lower in women with BMI ≥25 compared to BMI < 25 kg/m2 (RR 0.17, 95% CI 0.15–0.20). For CPR, the pooled data from 9 studies showed that there was no significant difference (RR 1.01, 95% CI 0.86-1.20). There was no statistical difference in the miscarriage rate between the two cohorts (RR 0.72, 95% CI 0.52-1.00). Our meta-analysis showed that women with raised BMI had a lower LBR. However, there was no significant difference with CPR or miscarriage rate. The inconsistent finding highlights a need for further research to assess the impact of BMI on IUI outcomes. Nevertheless, weight loss counselling should be offered to patients with a raised BMI to reduce the associated perinatal morbidity.