Int J Clin Exp Med 2013;6(10):991-995 www.ijcem.com /ISSN:1940-5901/IJCEM1309012

Original Article Overweight and obesity adversely affect outcomes of assisted reproductive technologies in polycystic ovary syndrome patients Zhiqin Bu*, Wei Dai*, Yihong Guo, Yingchun Su, Jun Zhai, Yingpu Sun Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, People’s Republic of China. *Equal contributors. Received September 13, 2013; Accepted October 18, 2013; Epub October 25, 2013; Published October 30, 2013 Abstract: Overweight and obesity may have negative impact on IVF/ICSI treatment outcomes. However, it is not clear whether overweight and obesity have impact on IVF/ICSI outcomes in PCOS patients. The aim of this study was to examine the effect of overweight and obesity on IVF/ICSI treatment outcomes in PCOS patients treated with GnRH agonist long protocol. This retrospective study was conducted in a reproductive medicine center from January 2009 to June 2013. IVF/ICSI characteristics and outcomes were analyzed in 688 PCOS patients according to their BMI. A total of 409 normal weight patients (group A, 18.5 kg/m2 ≤ BMI 0.05), but the difference was not statistically significant. In conclusion, overweight and obesity is associated with unfavorable IVF/ICSI outcomes in PCOS patients treated with GnRH agonist long protocol. Keywords: Overweight, obese, PCOS, in vitro fertilization

Introduction Overweight and obesity, one of the greatest nutritional problems in the world, are evidenced to have relationship with an increased risk of infertility [1-3]. According to several published literatures, the prevalence of overweight in Chinese women was 13.1% in 1991 [4], and increased to 21.7% 10 years later [5]. Body mass index (BMI), calculated as weight in kilograms divided by height in meters, is considered to be the common measure of overweight and obesity. Up to date, many studies of the impact of BMI on outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment have been conducted, while the results are conflicting. Some investigators showed no significant impact of BMI on response to ovarian stimulation, and pregnancy outcomes [6-8]. In contrast, other studies have demonstrated that overweight and obesi-

ty may adversely affect cumulative live birth rates [9], increase risk of spontaneous abortion [10, 11]. Polycystic ovary syndrome (PCOS) is a heterogeneous and endocrine disorder that affects 6-10% of women of reproductive age [12, 13]. It is not rare to see PCOS patients attending reproductive medicine center, because PCOS account for nearly 73% of anovulatory infertility cases [14], and 40%-60% of women with PCOS are overweight or obese [15]. However, the impact of overweight and obesity on assisted reproductive technologies outcomes in patients with PCOS is still unknown, because data analyzing IVF/ICSI outcomes in PCOS patients are limited. Thus, the aim of this study is to assess whether overweight or obese PCOS patients treated with GnRH agonist long protocol have the same outcomes of IVF/ICSI when compared with normal weight patients.

BMI and IVF in PCOS patients Table 1. Characteristics of IVF/ICSI treatment according to BMI No. of patients Age (years) Basal FSH (mIU/mL) Basal LH (mIU/mL) BMI (kg/m2) Days of stimulation Total Gonadotropins (IU) Peak E2 (pg/mL) No. of oocytes retrieved No. of fertilized oocytes (2PN) No. of high quality embryos

Group A 18.5 kg/m2 ≤ BMI 0.05).

Table 2. IVF/ICSI treatment outcomes according to BMI No. of patients No. of embryo transferred Implantation rate (%) Clinical pregnancy rate (%)

Group A 18.5 kg/m2 ≤ BMI 0.05).

Materials and methods Subjects and study design A total of 688 women with PCOS who underwent their first IVF or ICSI treatment from January 2009 to June 2013 in our center were included in this retrospective cohort study. All these patients diagnosed with PCOS met the Rotterdam 2003 criteria and underwent IVF/ ICSI treatment using GnRH agonist long protocol [16]. According to their BMI, the patients were divided into two groups: Group A included 409 patients with BMI ≥18.5 kg/m2 and

Overweight and obesity adversely affect outcomes of assisted reproductive technologies in polycystic ovary syndrome patients.

Overweight and obesity may have negative impact on IVF/ICSI treatment outcomes. However, it is not clear whether overweight and obesity have impact on...
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