The Influence Of Female And Male Body Mass Index On IVF/ICSI Outcomes

ObjectiveTo investigate the influence of female and male body mass index on in vitro fertilization(IVF) and intracytoplasmic sperm injection (ICSI) outcome.Materials and methodsA case control and cohort study.First,5596IVF/ICSI fresh cycles were collected inReproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University fromsep2009to Jun2013. According to the body mass index of Asian obesity standards, femalewere divided into four groups: low weight group(BMI<18.5kg/m2), normal weight group(18.5kg/m2≤BMI<23kg/m2)， overweight(23kg/m2≤BMI<25kg/m2) and obese group(BMI≥25kg/m2). Demographic features, ART parameters and outcomes between differentBMI groups were compared, normal weight group was chosen as control group.Secondly，5597male data in IVF/ICSI cycles were collected in Reproductive MedicineCenter of the First Affiliated Hospital of Zhengzhou University from sep2009to Jun2013.According to the body mass index standards,the males were divided into four groups: lowweight group(BMI<18.5kg/m2), normal weight group (18.5kg/m2≤BMI<23kg/m2)， overweight(23kg/m2≤BMI<25kg/m2) and obese group (BMI≥25kg/m2). Sperm quality andembryo quality of different groups were compared with normal weight group.Thirdly, it was a retrospective cohort study,data information came from ReproductiveMedicine Center of the First Affiliated Hospital of Zhengzhou University from Sep2009toJun2013There are32371cycles in all. The author got rid of11022frozen cycles and chose12629fresh IVF/ICSI cycles at last. To analyze the independent or combined associationsbetween female and male body mass index (BMI) on the outcomes after treatments with invitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). The software of SPSS15.0was used to analyze the data, using T-test、 Chi-Square Test、 One-Way ANOVA、Correlation Analysis、Multivariate logistic regression and so on.ResultsFirstly, Female BMI increased along with their age(P＜0.05). The total amount ofgonadotropin, days of gonadotropin of obese group was higher than normal weight group, thedifference was statistically significant (P<0.05). The number of oocytes retrieved, two formernuclear, merogenesis in obese group are more than that in normal weight group，the differencewas statistically significant (P<0.05). However, the number of good quality embryo betweennormal weight group and obese group was not statistically significant.Other outcomeparameters of different BMI groups have no significant difference (P>0.05). The rate ofmiscarriage of obese group was higher than normal weight group and the live birth rate ofobese group was lower than normal weight group, that was statisticallysignificant(P<0.05).The clinical pregnancy rate of different BMI groups was no significantdifference (P>0.05).Secondly, There was an nonlinear association between male BMI and semen volume andnormal morphology sperm rate in IVF cycles(P＜0.05)。In ICSI cycles the association wasalso nonlinear between male BMI and a-level, a+b-level, sperm viability rate(P＜0.05)。The male BMI increased along with their age(P＜0.05).In IVF cycles,the semen volume ofnormal BMI group was more than obese group(P<0.05). In ICSI cycles the density ofsemen,a-level,a+b-level sperm rate and sperm survival rate in obese group was higher thannormal BMI group and that was statistically significant(P<0.05).The number of normalfertilization, high quality embryo and Portable embryo number of obese group were lessthan normal weight group(P<0.05). There was no significant difference in other groups(P>0.05). Thirdly, In total,12,660cycles with IVF，ICSI and R-ICSI, of which33.8%ended in livebirth (34.4%of IVF and34.6%of ICSI and31%of R-ICSI). The live birth rate of underweight group and obese group were both lower than normal BMI groups. The decreased18.5%（95%CI0.718-0.925）and20.6%（95%CI0.680-0.923）respectively.Although therewas no statistically significant between over weight group and normal weight group. The livebirth rate had a downtrend. Both Female’s BMI≥25kg/m2with male’s BMI＜25kg/m2andfemale’s BMI＜25kg/m2with male’s BMI≥25kg/m2groups had a downtrend of live birthrate，the OR was0.805and0.815respectively（P＜0.05）.But in both female and male’s BMI≥25kg/m2groups, there was no significant difference of the live birth rate(P>0.05).ConclusionsBoth female and male BMI rose with the increased age. The total amount ofgonadotropin, days of gonadotropin rose with the increased female BMI in IVF/ICSI cycles.Both low and exorbitant female BMI have negative effect on live birth after IVF treatmentsby influencing embryo quality.Male BMI was related to sperm quality. Exorbitant male BMIhave negative effect on live birth after IVF treatments by influencing the sperm quality andembryo quality. The association between BMI and ICSI outcome was less clear.