The influence of female and male body mass index on live births after assisted reproductive technology treatment a nationwide register based cohort study

Capsule:
Both female and male body mass indices (BMI) is important for the outcome of in vitro fertilization/intracytoplasmic sperm injection treatments. Increased female and male BMIs negatively affect the chance of live birth, especially after IVF.

Authors:
Gitte Lindved Petersen, M.Sc., Lone Schmidt, M.D., Ph.D., Anja Pinborg, M.D., Mads Kamper-Jørgensen, M.Sc., Ph.D.

Volume 99, Issue 6, Pages 1654-1662, May 2013

Abstract:

Objective:
To investigate the independent and combined associations between female and male BMI on the probability of achieving a live-birth following treatments with IVF or ICSI under adjustment for relevant covariates.

Design:
Population-based cohort study.

Setting:
Danish national registers.

Patient(s):
Patients with permanent residence in Denmark receiving IVF or ICSI treatment with use of autologous oocytes between January 1, 2006, and September 30, 2010.

Intervention(s):
None.

Main Outcome Measure(s):
Live-birth. Analyses were adjusted for age and smoking at treatment initiation and results stratified by BMI groups and presented by IVF/ICSI treatment.

Result(s):
In total, 12,566 women and their partners went through 25,191 IVF/ICSI cycles with 23.7% ending in a live-birth. Overweight and obese women with regular ovulation had reduced odds of live-birth (adjusted ORs 0.88 (95%CI 0.79-0.99) and 0.75 (95%CI 0.63-0.90), respectively) compared to normal weight. IVF-treated couples with both partners having BMI≥25 had the lowest odds of live-birth (adjusted OR=0.73; 95%CI 0.48-1.11) compared to couples with BMI<25. BMI showed no significant effect on chance of live-birth after ICSI.

Conclusion(s):
Increased female and male BMI both independently and combined negatively influenced live-birth after IVF treatments. With ICSI, the association with BMI was less clear.

  • Audrey Gaskins

    This study does an excellent job at addressing the potential interaction between male and female BMI and live birth after IVF treatment and presents many intriguing results. In contrast to typical thinking this study shows that couples in which the man is overweight and female is normal weight have a reduced risk of live birth equal to (or possibly greater) than couples in which the female is overweight and male is normal weight. My one question was whether the authors had any information on primary infertility diagnosis in these couples?

    • Gitte Lindved Petersen

      Dear Audrey,
      Thank you for your comment and question.
      We do have access to information regarding primary and secondary infertility
      diagnosis for both women and men. We used primary female diagnosis to stratify
      analyses according to ovulatory status. Further stratification according to
      specific infertility diagnoses is possible, but small groups easily hinders
      firm conclusions.
      Kind regards,
      Gitte Lindved Petersen

      • Audrey Gaskins

        Gitte, thanks for your reply! Did you stratify by primary male factor infertility diagnosis? It would be interesting to see whether men who are overweight but have no male factor infertility diagnosis have the same reduced live birth rates seen in your paper when you looked across all couples. There might not be the power to do this but could be interesting!

        • Gitte Lindved Petersen

          In table 2 we present results stratified according to IVF and ICSI treatment and for IVF+ICSI. Because IVF is usually chosen for couples with no male factor infertility and ICSI usually for male factor infertility, these results may indicate that the associations between BMI and chance of live birth are different according to
          male factor infertility.
          KR, Gitte

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