The Effects of Oocyte Donor and Recipient BMI on Live Birth Rates and Pregnancy Outcomes following Assisted Reproduction Open Access
Xu, Jiaxin (Spring 2020)
Abstract
Background. Excess body weight is a risk factor for impaired fertility in women conceiving both with and without medical assistance. However, whether excess body weight negatively influences female fertility on the level of the oocyte and/or uterine environment remains unclear. Vitrified donor oocyte ART offers an ideal model to study these effects.
Objective. To investigate the effects of oocyte donor and recipient BMI on outcomes of vitrified donor oocyte ART.
Design. Retrospective cohort study.
Setting. Reproductive Biology Associates, a private fertility center in Sandy Springs, Georgia, USA.
Patients. 338 oocyte donors and 932 recipients who underwent a total of 1651 embryo transfer cycles between 2008 and 2015.
Intervention(s). None.
Main outcome measure(s). Live birth, defined as the delivery of at least one live born infant per embryo transfer cycle. Secondary outcomes included positive pregnancy test, miscarriage, birth weight, and gestational length.
Results. There were no significant associations between donor BMI and probability of positive pregnancy test, miscarriage, and live birth. Recipients with a BMI ≥35 kg/m2 had a significantly higher probability of pregnancy (RR 1.13, 95% CI 1.02, 1.25) and live birth (RR 1.26, 95% CI 1.07, 1.49) compared to normal weight recipients (p-trend=0.001 and 0.003, respectively). Among singleton live births, recipients with a BMI<18.5 kg/m2 had a lower risk of delivery in a given week (HR 0.64 95% CI 0.43, 0.95) while women with a BMI ≥35 kg/m2 had a higher risk of delivery in a given week (HR 1.45 95% CI 0.96, 2.20) compared to normal weight women. Obese recipients also had a higher risk of having a low birth weight baby (RR 1.76 95% CI 1.02, 3.02) compared to normal weight women. Donor BMI was not associated with birthweight or gestational length.
Conclusions. In the setting of vitrified donor oocyte ART, recipient BMI was positively associated with probability of live birth but negatively associated with gestational length and birthweight among singleton births. Our results suggest that impaired oocyte quality rather than endometrial receptivity may be the overriding factor influencing ART outcomes in obese women using autologous oocytes.
Table of Contents
Introduction 1
Materials and Methods 2
Results 7
Discussion 10
References 15
Tables 17
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