The Relationship Between Body Mass Index Of Infertile Couples And IVF/ICSI Outcomes

ObjectiveTo investigate the relationship between body mass index of female before pregnancy andmale of the infertile couples and IVF/ICSI outcomes. As well as comparison IVF/ICSIoutcomes,birth outcomes and their offsprings among their weight gain in pregnancy，BMIgrowth in pregnancy or BMI before delivery.MethodsThe author retrospectively collected458cases of infertile couples’data after IVF/ICSI inReproductive Center of General Hospital of Ningxia Medical Universityfrom April2008to O-ctober2012, and did the prospect follow-up visit of67cases of the condition of pregnant fe-male and their offsprings after IVF/ICSI from August2011to April2012. According to bod-y mass index (BMI) of national obesity standards in2008, Non-PCOS patients can be divi-ded into three groups:low weight group(BMI<18.5kg/m~2), normal weight group (18.5kg/m~2≤BMI<24kg/m~2)，overweight and obese group (BMI≥24kg/m~2). PCOS and males patientsand male can be divided into two groups,non-overweight group(BMI＜24kg/m~2) and over-weight and obese group(BMI≥24kg/m~2). According to the2009U.S. pregnancy weight g-ain guidelines, the upper limit of the normal pre-pregnancy BMI groups during pregnancy we-ight gain is bounded, the follow-up of IVF/ICSI pregnant women were divided into normalweight gain and excessive weight gain group. To analyze general situation (BMI, age,durationof infertility, sterility, infertility reasons, progesterone, basic follicle stimulating hormone bFS-H, basic luteinizing hormone bLH，basic estradiol bE2, basic testosterone bT, basic prolactinbPRL, basic the number of antral follicles AFC), ovulation outcomes (the total amount of gon -adotropin,days of gonadotropin, the injection of chorionic gonadotropin estradiol levels andendometrial thickness,number of oocytes retrieved, number of mature eggs，the number offrozen embryos, mature egg rate, fertilization rate, good quality embryo, ovarian hyperstimu-lation syndrome incidence, embryo implantation rate, clinical pregnancy rate, incidence ofovarian hyperstimulation syndrome OHSS), abortion rate between different BMI groups ofnon-PCOS and male. To compare different BMI groups of non-PCOS woman with IVF/ICSIassisted reproductive, different weight gain during pregnancy or BMI growth in pregnancy w-ith pregnancy complication (gestational hypertension disease PIH, gestational diabetes GDM),birth outcomes (preterm birth rate,cesarean section rate),status of offspring born (birth weight,LBWI incidence of low birth weight infants, the incidence of macrosomia and congenital ma-lformation). Analysis the relation between gestational age or birth weight and BMI before d-elivery. To compare different BMI groups of singleton pregnancies of non-PCOS womanwith general condition, pregnancy complications, birth outcomes and offspring birth inform-ation. To compare different BMI groups of PCOS woman with general situation, ovulationoutcomes, abortion rate, early miscarriage rate and live birth rate. Analysis the relationshipboth gestational age and birth weight offspring with pre-pregnancy BMI, weight gain duringpregnancy,BMI before childbirth.One-way ANOVA was used to compare the mean of multi-groups.T-test was used tocompare the mean between two groups. When the variance is heterogenic, the rank su-m testwas used. Chi-square test is used in comparison of rate.Multiple linear regression model wasused to analyze IVF/ICSI outcome and linear relationship of factors. The correlation analysisof the correlation between the two variables.The results1. The relationship between body mass index of female and the outcomes of IVF/ICSI(1) The relationship between body mass index of female before pregnancy and the outcomesof IVF/ICSI ①Any ovulation program or long program: There is significant difference between BMI ofnon-PCOS patients pre-pregnancy of different BMI groups(P＜0.05). The bFSH and bLH ofunderweight group is higher than normal weight group and overweight and obese group, thedifference was statistically significant (P<0.05). The other general situation and pregnancy o-utcomes of different BMI groups was no significant difference (P>0.05).Any ovulation program:The mature egg rate and fertilization rate of underweight group isless than normal BMI and overweight and obese group, the difference was statistically sign-ificant (P<0.05). The other ovulation outcomes of different BMI groups was no significantdifference (P>0.05).Among the singleton pregnancy of pre-pregnancy different BMI groups,pregnancy complication and birth outcomes and their offspring were no significant difference(P>0.05).Long program：The mature egg rate of underweight group is less than normal BMI andoverweight and obese group, the difference was statistically sign-ificant (P<0.05). Fertiliza-tion rate for pair-wise compareison among the three groups after long program, the differen-ce was statistically significant (P<0.05).②The general situation of PCOS patients between non-overweight group and overweig-ht and obese group were no significant difference (P>0.05). PCOS patients with non-overw-eight group, the day of hCG serum E2and high-quality embryos was significantly higher thanthe overweight and obese group, the difference was statistically significant (P<0.05). Theother ovulation outcomes, abortion rate, early miscarriage rate and live birth rate between thetwo groups of PCOS was not statistically significant (P>0.05).③There is no relationship to be found between maternal pre-pregnancy BMI andoffspring malformations.(2)The relationship between weight gain during pregnancy and the outcomes of IVF/ICSI①The difference of weight gain during pregnancy between little group and too muchgroup was statistically significant (P<0.05). The case of pregnancy comlacation,childbirth outcomes and incidence of congenital malformation between the two groups, the differencewas not statistically significant (P>0.05).②Different groups of BMI increase during pregnancy pregnancy IVF/ICSI singlepregnancy outcome comparison shows that the difference between pre-pregnancy BMI andBMI increase was statistically significant (P <0.05). Maternal age, infertility years, case ofpregnancy and offspring birth weigh between the two groups t was no significant difference(P>0.05).There is correlation between gestational age after IVF/ICSI and,but no correlation withpre-pregnancy weight, pre-pregnancy BMI, the BMI before delivery and pregnancy weightgain was (P>0.05).There was a positive linear relationship between single fetal birth weightand weight gain during pregnancy (P<0.05),while maternal age, pre-pregnancy weight,pre-pregnancy BMI and BMI before delivery had no correlation with it(P>0.05).2. The relationship between body mass index of male and the outcomes of IVF/ICSI(1)Sperm density and motility are significant different among four BMI groups(P<0.05).Sperm motility rate on total, a+b-level, a-level and b-level in overweight group were higherthan that in normal BMI group(P<0.05). Compare with mildly obesity and overweight group,sperm density and motility rate were significantly lower in severe obesity group (P <0.05).(2) The BMI of different male group after IVF or IVF/ICSI were significantly different(P<0.05), age of infertility couple, BMI of female, infertility types, causes of infertility,treatment outcomes and live birth rate was no significant difference (P>0.05).The BMI of male group after ICSI were statistically significant (P<0.05).But age ofinfertility couple, infertility types, causes of infertility, BMI of female，the number of frozenembryos, high-quality embryo rate, clinical pregnancy rate，abortion rate and live birth ratebetween different BMI groups was no significant difference (P>0.05). And eggs ofoverweight and obese group is greater than the normal group, the difference was statisticallysignificant(P<0.05).The fertilization rate of normal group was higher than the overweight and obese group, the difference was statistically significant (P<0.05).Conclusions1.High or low BMI of female of non-PCOS under38years old doesn’t affect reactivityof ovulation of women.2. High or low BMI can affect egg quality of female under38years old in non-PCOSpatients, but BMI does not affect the embryo quality,IVF/ICSI pregnancy and offspringbirth;3. Overweight and obese made embryo quality of PCOS patients lower;4. There is no relationship to be found between maternal pre-pregnancy BMI andoffspring malformations, further data accumulation is needed;5. The weight gain during pregnancy and birth weight was positively relevance.6. Semen quality is better in overweight infertility men than that in nomal BMI’s; Severeobesity made an adverse impact on semen quality in male.7. High or low of males’ BMI has no significant effect on the final outcomes ofIVF/ICSI.