Abstract
Objective: To evaluate the
impact of elevated body mass index (BMI) on short- and long-term
outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm
injection (ICSI) treatments.
Design: Retrospective cohort study.
Setting: Teaching hospital.
Population: Overall, 7229 patients undergoing IVF/ICSI fresh
cycles and subsequent frozen embryo transfer cycles during 2014-2020.
Methods: The patients were divided into normal (18.5–24.9
kg/m2) and high BMI (≥ 25 kg/m2)
groups. Subgroup analyses were performed based on the boundary of 38
years old. Multivariate analysis was used to determine whether BMI was
associated with live birth rate (LBR) or cumulative live birth rate
(CLBR).
Main Outcome Measure: Ovarian response, pregnancy outcomes, and
safety for both mother and fetus.
Results: For younger women (< 38y), CLBR was
significantly reduced in the high BMI subgroup compared to the normal
BMI control (73.7% vs 76.8%, p = 0.008) and was accompanied by fewer
retrieved oocytes and available embryos. Meanwhile, the incidences of
cesarean section (92.9% vs 87.1%, p < 0.001), hypertensive
disorders of pregnancy (6.7% vs 3.1%, p < 0.001), fetal
macrosomia (4.7% vs 2.8%, p = 0.002) and birth defects involving cleft
lip and palate (0.4% vs 0.1%, p = 0.030) were significantly higher
than the normal BMI group. However, no such differences were observed
among older women (≥ 38y). Multivariate analysis revealed that high BMI
was a risk factor for CLBR (OR = 0.837, 95% CI: 0.729–0.96).
Conclusions: Elevated BMI has a greater adverse impact on
younger women.
Funding: This study was supported by grants from the National
Natural Science Foundation of China (grant no. 81771582).
Keywords: BMI, CLBR, obstetric complications, neonatal
outcomes, birth defects