Abstract:
One half of women of reproductive age are either overweight or obese. High prevalence seeking ART. Impact of elevated BMI on IVF outcomes remains somewhat controversial. Obesity is associated with: ovulatory dysfunction, reduced ovarian responsiveness to ovulatory drugs, altered oocyte as well as endometrial function, increased risk of infertility & lower birth rates after IVF. Increased risk of developing maternal & fetal complications during pregnancy: miscarriage, preterm birth, fetal deaths, and pregnancy complications. Men with obesity may exhibit impaired reproductive function. No increased rates of aneuploidy with increasing BMI suggesting that poor oocyte “quality” in obese patients may be due to factors more complex than chromosomal competence. Molecular alterations in the oocytes of obese patients have been observed in RNA-seq studies Each 5-unit increase in female BMI is associated with statistically significant decrease in risk by 5% and 7%for CPR and LBR, respectively & 9% increase in the relative risk of miscarriage. No medical or ethical directive for adopting a society-wide BMI threshold for denying a patient or couple access to infertility treatment. Evaluation before an IVF cycle with a multidisciplinary team to determine the safety of oocyte retrieval under anesthesia, considering factors such as BMI and comorbidities. No compelling evidence of the value of lifestyle intervention for weight loss on LBR. Conflicting data on the effects of bariatric surgery on reproductive outcomes have been published. Bariatric surgery had no significant impact on IVF success.
