Effect Of Obesity On IVF/ICSI Outcomes In Infertile Patients

Objective To explore the effects of obesity on the assisted reproduction outcome in the course of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI), and provide theoretical basis for getting a satisfactory outcome.Methods 968 infertile patients who received IVF/ICSI using short acting gonadotrophin releasing hormone agonist(Gn RHa) long protocol in Reproductive Center of Tangshan Maternity and Children Health Hospital during January 2011 to May 2015 was selected, The Ovarian Hyper-stimulation(COH) parameters and pregnancy outcomes was recorded in the course of IVF/ICSI. All patients were classified according to BMI levels(normal weight: n=479, 18.5kg/m2?BMI < 23.0kg/m2 and obese: n=489, BMI ?23.0kg/ m2,).Compared the number of retrieved oocytes, MII oocytes, 2PN embryos, transferable embryos, and high quality embryos, clinical pregnancy, early abortion, and live birth rates between two groups using the single factor analysis. Then eliminated the interference of the basic datas through multi-factor analysis and analysed the effects of obesity, an independent risk factor, on IVF/ICSI assisted reproduction outcomes, According to the WHO "Redefine of obesity and it's prevention-treatment in Asia-pacific" standards, Obese infertility patients were divided into 3 groups according to the degree of obesity. Overweight group(n=232, 23.0kg/m2?BMI<25.0kg/m2), Mild obese group(n=185, 25.0kg/m2?BMI<30.0kg/m2), Severe obese group(n=72, BMI?30.0kg/m2). Compared the assisted reproduction outcome indexes among the three groups, and analysed the effects of obese degree on IVF/ICSI assisted reproduction outcomes.Results 1 There were no significant difference in duration of infertility, distribution of infertility types, b AFC, way of fertilization between normal weight group and obese group(P>0.05). There were significant difference in patients' age, b FSH, the dosage and duration of gonadotrophin(Gn) between two groups(P<0.05). 2 Compared with normal weight group, the number of retrieved oocytes, 2PN embryos,transferable embryos and clinical pregnancy rate were significantly lower in obese group, while the early abortion rate was increased significantly(P<0.05). There were no significant difference in M?oocytes, high quality embryos and live birth rate between two groups(P>0.05). 3 Eliminated the interference of patients' age, b FSH, the dosage and duration of Gn through multi-factor analysis, we found that the number of retrieved oocytes, 2PN embryos and number of transferable embryos were significantly lower with the increase of body mass index(BMI)(P<0.05). With the growth of the BMI, the clinical pregnancy rate was significantly lower, while the early abortion rate was increased significantly(P<0.05). 4 Analyzed the effect of obesity on assisted reproduction outcomes, we found that the number of retrieved oocytes and transferable embryos were significantly lower in mild obese group and overweight group(P<0.01). Compared with overweight group, clinical pregnancy rate was significantly lower in severe obese group(P<0.01). With the aggravate of obese degree, early abortion rate presented a trend of increasing, but therewas no statistically significant(P>0.05).Conclusions 1 Obesity was an independent risk factor for infertile patients who underwent IVF/ICSI, it lead to lower number of retrieved oocytes, number of transferable embryos, clinical pregnancy, and higher early abortion rate. 2 A detrimental impact of higher body mass index was observed. With the aggravate of obese degree, number of retrieved oocytes, transferable embryos, and clinical pregnancy appeared a significantly downward trend,but early abortion rate is no longer rise.