Body mass index (bmi) is not associated with ovarian response to gonadotropin during ivf/icsi treatment: an evaluation of 4499 ivf/icsi cycles

Abstract Study question Is there an association between body mass index (BMI) and ovarian response in IVF/ICSI treatment? Summary answer BMI does not seem to be associated with the ovarian response to gonadotropin. What is known already Obesity is becoming an increasingly widespread health problem. Elevated BMI in patients who undergo assisted reproduction technology has been associated with higher doses of gonadotropins, higher risks of ovarian hyperstimulation syndrome, increased cancellation rates, and lower oocyte recovery compared to women with normal BMI. In addition, overweight and obese women submitted to IVF may present reduced rates of clinical pregnancy and live births and an increased miscarriage rate. However, population differences should be considered. Study design, size, duration This prospective cohort study included 4499 women who underwent IVF/ICSI cycles. Only one cycle per couple was considered. Inclusion criteria included normal karyotype, presence of two ovaries as observed by ultrasound examination, and no history of ovarian surgery, endometriosis, hydrosalpinx, infection, or endocrine disorders. Patients were stratified into four groups by BMI: <18.5 kg/m2 (underweight); 18.5-24.9 kg/m2 (normal weight); 25-29.9 kg/m2 (overweight); and ≥30 kg/m2 (obesity). Participants/materials, setting, methods The BMI values were associated with age, anti-Müllerian hormone (AMH) levels, antral follicle counts (AFC), total dose of FSH and LH, number of follicles and number of retrieved oocytes (total and metaphase II) of IVF/ICSI cycles. The statistical analyses for group comparisons were performed using t test, Mann–Whitney test and the Kruskal–Wallis test. Main results and the role of chance No statistically significant differences were observed between BMI groups regarding age, AMH levels, AFC, dose of gonadotropin used (FSH and LH), days of stimulation, number of follicles and number of retrieved eggs (total and metaphase II). Table 1 summarizes the results. Limitations, reasons for caution A possible limitation is the cross-sectional nature of the data. Differences in sample size between BMI groups may have influenced the results. Wider implications of the findings Against common sense in the literature, the results did not reveal a relationship between BMI and the ovarian response to gonadotropins. BMI as an additional tool in the individualization of ovarian stimulation protocols should be reviewed. Trial registration number Not applicable.