The relationship between embryo quality and obesity in IVF patients: a single-center retrospective study

Abstract

Purpose: The aim of this study is to retrospectively compare the relationship between female obesity and embryo quality and pregnancy outcome.
Materials and methods: In this retrospective study, which received approval by the ethical committee, data of in vitro fertilization (IVF) patients (n:542) between January 2019 and August 2021 were examined. The patients were divided into four groups: Group 1, Body Mass Index (BMI) <18.50 kg/m2 (n:16); Group 2, BMI 18.50-24.99 kg/m2 (n:263); Group 3, BMI 25.00-29.99 kg/m2 (n:156); Group 4, BMI ≥30 kg/m2 (n:107). Demographic characteristics of patients, baseline hormone levels, treatment protocols employed, counts of collected oocytes, day of embryo transfer, transferred embryo quality, a positive pregnancy test, and live births were collected, and statistical analysis was performed.
Results: There were no significant differences between the groups in terms of age, collected oocyte count, number of mature oocytes, maturation rate (p>0.05). Group 4 showed a statistically significant decrease in the number of 2PN (p=0.014) and fertilised oocyte count (p=0.006) compared to Group 2. When comparing pregnancy outcomes based on BMI groups, it was found that obesity did not significantly affect positive/negative pregnancy rates, live birth rates, miscarriage rates, biochemical pregnancy rates among the groups (p>0.05). Logistic regression analysis indicated a decrease in embryo quality with increasing age. Multiple regression analysis (MRA) results showed that a good quality of the transferred embryo had a positive impact on achieving a positive pregnancy outcome. The presence of pregnancy was negatively affected by increasing age. In Group 1 and Group 2, there were significantly more Day-5 transfers than in Group 4 (p=0.008).
Conclusion: This study showed that obese patients had a lower rate of Day 5 embryos compared to non-obese patients. However, no difference was found between BMI and pregnancy rates. The development of good quality embryos had a favourable effect on pregnancy outcomes, whereas increasing age had a negative effect. The present data suggest that further studies evaluating the mechanism underlying the effect of obesity on embryo development are warranted.

Keywords

• Assisted reproduction
• infertility
• oocyte
• body mass index
• embryo quality

Ethical Statement

The retrospective study was approved (approval date: 31/08/2021; approval number:16) by the ethical committee.

IVF hastalarında embriyo kalitesi ve obezite arasındaki ilişki: tek merkezli retrospektif bir çalışma

Abstract

Amaç: Bu çalışmanın amacı, kadın obezitesi ile embriyo kalitesi ve gebelik sonuçları arasındaki ilişkiyi retrospektif olarak karşılaştırmaktır.
Gereç ve yöntem: Etik kurul onayı alan bu retrospektif çalışmada, Ocak 2019-Ağustos 2021 tarihleri arasında in vitro fertilizasyon (IVF) hastalarının (n:542) verileri incelendi. Hastalar dört gruba ayrılmıştır: Grup 1, Vücut Kitle İndeksi (VKİ) <18,50 kg/m2 (n:16); Grup 2, VKİ 18,50-24,99 kg/m2 (n:263); Grup 3, VKİ 25,00-29,99 kg/m2 (n:156); Grup 4, VKİ ≥30 kg/m2 (n:107). Hastaların demografik özellikleri, başlangıç hormon düzeyleri, uygulanan tedavi protokolleri, toplanan oosit sayıları, embriyo transfer günü, transfer edilen embriyo kalitesi, pozitif gebelik testi ve canlı doğumlar toplanmış ve istatistiksel analiz yapılmıştır.

Bulgular: Gruplar arasında yaş, toplanan oosit sayısı, olgun oosit sayısı ve olgunlaşma oranı açısından anlamlı bir fark yoktu (p>0,05). Grup 4’de Grup 2’ye göre 2 PN sayısı (p=0,014) ve fertilize olan oosit sayısı (p=0,006) istatistiksel olarak anlamlı azalmıştı. VKİ gruplarına göre gebelik sonuçları karşılaştırıldığında, obezitenin gruplar arasında pozitif/negatif gebelik oranlarını, canlı doğum oranlarını, düşük oranlarını ve biyokimyasal gebelik oranlarını önemli ölçüde etkilemediği bulunmuştur (p>0,05). Lojistik regresyon analizi, artan yaşla birlikte embriyo kalitesinde azalma olduğunu göstermiştir. Çoklu regresyon analizi (MRA) sonuçları, transfer edilen embriyo kalitesinin iyi olmasının olumlu gebelik sonucu elde edilmesini olumlu yönde etkilediğini göstermiştir. Gebelik varlığı artan yaştan olumsuz etkilenmiştir. Grup 1 ve Grup 2'de, Grup 4'e kıyasla anlamlı derecede daha fazla 5. Gün transferi yapılmıştır (p=0,008).
Sonuç: Bu çalışma obez hastaların obez olmayan hastalara kıyasla daha düşük 5. Gün embriyo oranına sahip olduğunu göstermiştir. Bununla birlikte, VKİ ile gebelik oranları arasında fark bulunmamıştır. İyi kalitede embriyo gelişimi gebelik sonuçları üzerinde olumlu bir etkiye sahipken, artan yaş olumsuz bir etkiye sahiptir. Mevcut veriler, obezitenin embriyo gelişimi üzerindeki etkisinin altında yatan mekanizmayı değerlendiren daha ileri çalışmalara ihtiyaç olduğunu göstermektedir.

Keywords

• Yardımla üreme
• infertilite
• oosit
• vücut kitle indeksi
• embriyo kalitesi

Ethical Statement

Bu retrospektif çalışma etik kurul tarafından onaylanmıştır (onay tarihi: 31/08/2021; onay numarası:16).

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