Abstract
ObjectiveThe goal of this study was to assess the association between BMI and the possibility of conceiving a child through an assisted reproduction treatment.MethodsA study of cases and controls matched by age, with 394 patients that underwent treatment at GESTAR (assisted reproduction center), between 2013-2017. The association between BMI and the possibility of conceiving a child, analyzed through logistic regression.ResultsAmong the cases (successful treatments) 14% were obese, while in the control group (patients that did not get pregnant) the obesity rate was 21%. There was a significant difference (p<0,01) in the BMI, the number of recovered oocytes, normally fertilized oocytes and the number of transferred embryos. The Odds Ratio (OR) in SPSS was 0.26 ± (0.14, 0.50) - 95% CI, indicating that conceiving a child by assisted reproduction is 74 times lower in patients that are obese when compared to non-obese patients (p<0,001). And the Odds Ratio (OR) calculated by logistic regression in Stata 11 was 0.80 ± (0.76, 0.86), 95% CI, which indicates a 20% decrease in the possibility of conceiving for each point on the BMI scale.ConclusionObesity is associated with a lower conception likelihood through assisted reproduction technologies.
Highlights
Overweight women have higher incidences of anovulation and menstrual dysfunction, possibly caused by hormonal alterations, such as elevated secretion of gonadotropin releasing hormone, luteinizing hormone and androgens
The patients that participated in the study were characterized, according to the four BMI categories proposed by the WHO (WHO, 2004): BMI ≤ 18.4kg/m2, 18.5-24.9 kg/m2, BMI 25-29.9 kg/m2 and BMI ≥30kg/m2
The greater proportion of the patients that achieved having a child through assisted reproduction treatment (ART) (Cases), had a BMI between 20 and 25 kg/m2
Summary
Overweight women have higher incidences of anovulation and menstrual dysfunction, possibly caused by hormonal alterations, such as elevated secretion of gonadotropin releasing hormone, luteinizing hormone and androgens. In Latin America the prevalence of obesity in women that undergo assisted reproduction treatment (ART) is high, 42.4%. These patients are less susceptible to respond to clomiphene citrate, they require higher doses of gonadotropins during ovarian stimulation; they have higher cancellation rates and a lower number of retrieved oocytes, affecting the probabilities of clinical pregnancy or live births (Hamilton-Fairley et al, 1992; MacKenna et al, 2017). In Argentina, the prevalence of obesity is around 14% according to Elgart et al (2010) It is unknown how much the possibility of conceiving a child decreases as the patient's BMI increases
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