Obesity Proven to Decrease IVF Success Rates

I have been sharing details of outstanding presentations from te 65th American Society for Reproductive Medicine Annual International Conference.   A multicenter study confirmed that maternal obesity lowers IVF success rates and the health of the pregnancy.  The study was performed at U Michigan, Dartmouth, and Brigham and Women’s Hospitals.  However the data was abstracted from our IVF proferssional society SART’s database of nearly all IVF cycles in America.  I had a chance to see the data and chat with the authors.

The study looked at 48,682 IVF cycles. Women were categorized by BMI (adjusts for height and weight (here’s how to calculate yours)  There were 3 categories of BMI–Women were categorized by their body mass index (BMI) as normal (18.5-24.9), overweight (25.0-29.9), or obese (Class I, 30.0-34.9; Class II, 35.0-39.9, Class III, ≥40.0).

The odds of pregnancy were significantly reduced for obese women  9% , 28%, and 35%  for Class I, II, and III), and the odds of a live birth were reduced for overweight and obese women. 

Worse yet –the odds of stillbirth were increased more than twofold for obese women as was the odds of preterm birth.

Here’s the data they presented: 

The odds of pregnancy were significantly reduced for obese women (0.91, 0.72, and 0.65, respectively for Class I, II, and III), and the odds of a live birth were reduced for overweight and obese women (0.87, 0.80, 0.74, and 0.75, respectively). The odds of stillbirth were increased more than twofold for obese women, significantly for Class I and II. Among live births, the odds of early preterm birth significantly paralleled increasing obesity (1.26, 1.52, and 1.59, respectively for Class I, II, and III), and the odds of preterm birth were significantly increased for all women (1.16, 1.33, 1.38, and 1.34, respectively).

What You can Do About It:  Obviously the strongest recommendation is for weight loss.  In my practice at Gold Coast IVFwe individualize the approach for overweight women to maximize their chances of delivering a healthy baby.  Due to this we do not see this degree of adverse pregnancy rates.  Our interventions include

  1. aggressive screeing PRETREATMENT for all risk factors and optimization PRIOR to treatment.  This includes heart disease hypertension and diabetes and prediabetic insulin resistance
  2. Individualized diet and exercise programs
  3. Nutritional counseling and assistance
  4. Medication regimens tailored for weight
  5. Special techniques for insemination or embryo transfers in the obese women
  6. Special hi resolution ultrasound equipment for the obese
  7. Coordination with medical weight loss programs for those at weight extremes
  8. Coordination of care with patient’s Ob.

 See here for other breaking research on IVF and embryo genetic screening from ASRM. 

 

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