Abstract
Research question
Does maternal preconceptional body mass index (BMI) associate with mean blastocyst
euploidy rate (m-ER) per patient and live birth rate (LBR) after vitrified–warmed
euploid single embryo transfer (SET)?
Design
Observational study conducted between April 2013 and March 2020 at a private IVF clinic,
involving 1811 Caucasian women undergoing trophectoderm biopsy and comprehensive chromosome
testing. The outcomes of 1125 first vitrified–warmed euploid SET were also analysed.
Patients were clustered as normal weight (BMI 18.5–25; n = 1392 performing 859 SET), underweight (BMI <18.5; n = 160 performing 112 SET) and overweight (BMI >25; n = 259 performing 154 SET). m-ER per patient was the primary outcome. The secondary
outcomes were all clinical outcomes per euploid SET. All data were adjusted for confounders
through regression analyses.
Results
The m-ER per patient decreases as maternal BMI increases from 17 up to 22–23 before
reaching a plateau. A linear regression adjusted for maternal age confirmed this moderate
association (unstandardized coefficient B: –0.6%, 95% confidence interval [CI]: –1.1
to –0.1%, P = 0.02). All clinical outcomes were similar between normal weight and underweight
women. Overweight women, instead, showed higher miscarriage rate per clinical pregnancy
(n = 20/75, 26.7% versus n = 67/461, 14.5%; odds ratio [OR] adjusted for blastocyst quality and day of full
blastulation: 2.0, 95% CI: 1.1–3.6, P = 0.01) and lower LBR per SET (n = 55/154, 35.7% versus n = 388/859, 45.2%; OR adjusted for blastocyst quality and day of full blastulation:
0.67, 95% CI: 0.46–0.96, P = 0.03).
Conclusion
These data indicate a need for future research on more sensitive metrics to assess
body fat mass and distribution, as well as on the mechanisms leading to lipotoxicity,
thereby impairing embryo competence and/or endometrial receptivity. Overweight women
should be informed of their higher risk for miscarriage and, whenever possible, encouraged
to lose weight, especially before transfer.
Keywords
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Biography
Gemma Fabozzi graduated in Cellular and Molecular Biology at the University of Rome Tor Vergata in 2008 and obtained an M.Sc. in Clinical Embryology at the University of Leeds in 2011. She is an ESHRE-certified Senior Embryologist and Clinical Nutritionist working at GeneraLife in Rome, expert in quality, risk management and nutrition in IVF.
Article info
Publication history
Published online: July 22, 2021
Accepted:
July 12,
2021
Received in revised form:
July 5,
2021
Received:
March 12,
2021
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
