Mauro Cozzolino1, Juan Antonio García-Velasco2, Marcos Meseguer3, Antonio Pellicer4, Jose Bellver5. 1. IVI-RMA, IVI Foundation, Valencia, Spain; Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut; Rey Juan Carlos University, Madrid, Spain. Electronic address: mauro.cozzolino@ivirma.com. 2. Rey Juan Carlos University, Madrid, Spain; IVI-RMA Madrid, Madrid, Spain. 3. IVI-RMA, IVI Foundation, Valencia, Spain; IVI-RMA Valencia, Valencia, Spain. 4. IVI-RMA, IVI Foundation, Valencia, Spain; IVI-RMA Roma, Rome, Italy; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain. 5. IVI-RMA, IVI Foundation, Valencia, Spain; IVI-RMA Valencia, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, Faculty of Medicine, University of Valencia, Valencia, Spain.
Abstract
OBJECTIVE: To determine whether female body mass index (BMI) is associated with an increased risk of miscarriage after euploid embryo transfer. DESIGN: A retrospective, observational, multicenter cohort study. SETTING: University-affiliated in vitro fertilization center. PATIENT(S): In this study, 3,480 cycles of in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A) in the blastocyst stage and euploid embryo transfer were divided into four groups according to patient BMI. INTERVENTION(S): In vitro fertilization with PGT-A. MAIN OUTCOME MEASURE(S): The primary outcome was the miscarriage rate, which included both biochemical and clinical miscarriages. Secondary outcomes were implantation, pregnancy, clinical pregnancy, and live birth rates. RESULT(S): Cycles were divided into four groups according to BMI (kg/m2): underweight (<18.5; n = 155), normal weight (18.5-24.9; n = 2,549), overweight (25-29.9; n = 591), and obese (≥30; n = 185). The number of PGT-A cycles per patient was similar in the four groups. Fertilization rate, day of embryo biopsy, technique of chromosomal analysis, number of euploid embryos, number of transferred embryos, and method of endometrial preparation for embryo transfer were similar in the four BMI groups. Miscarriage rates were significantly higher in women with obesity compared to women with normal weight, mainly due to a significant increase in the clinical miscarriage rates. Live birth rates also were lower in women with obesity. Obesity in women and day 6 trophectoderm biopsy were found to influence the reduced live birth rate. CONCLUSION(S): Women with obesity experience a higher rate of miscarriage after euploid embryo transfer than women with a normal weight, suggesting that other mechanisms than aneuploidy are responsible for this outcome.
OBJECTIVE: To determine whether female body mass index (BMI) is associated with an increased risk of miscarriage after euploid embryo transfer. DESIGN: A retrospective, observational, multicenter cohort study. SETTING: University-affiliated in vitro fertilization center. PATIENT(S): In this study, 3,480 cycles of in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A) in the blastocyst stage and euploid embryo transfer were divided into four groups according to patient BMI. INTERVENTION(S): In vitro fertilization with PGT-A. MAIN OUTCOME MEASURE(S): The primary outcome was the miscarriage rate, which included both biochemical and clinical miscarriages. Secondary outcomes were implantation, pregnancy, clinical pregnancy, and live birth rates. RESULT(S): Cycles were divided into four groups according to BMI (kg/m2): underweight (<18.5; n = 155), normal weight (18.5-24.9; n = 2,549), overweight (25-29.9; n = 591), and obese (≥30; n = 185). The number of PGT-A cycles per patient was similar in the four groups. Fertilization rate, day of embryo biopsy, technique of chromosomal analysis, number of euploid embryos, number of transferred embryos, and method of endometrial preparation for embryo transfer were similar in the four BMI groups. Miscarriage rates were significantly higher in women with obesity compared to women with normal weight, mainly due to a significant increase in the clinical miscarriage rates. Live birth rates also were lower in women with obesity. Obesity in women and day 6 trophectoderm biopsy were found to influence the reduced live birth rate. CONCLUSION(S): Women with obesity experience a higher rate of miscarriage after euploid embryo transfer than women with a normal weight, suggesting that other mechanisms than aneuploidy are responsible for this outcome.
Authors: Pedro Brandão; Antonio Pellicer; Marcos Meseguer; José Remohí; Nicolás Garrido; Juan Antonio García-Velasco Journal: Reprod Biomed Online Date: 2022-05-29 Impact factor: 4.567
Authors: María Del Carmen Nogales; María Cruz; Silvia de Frutos; Eva María Martínez; María Gaytán; Marta Ariza; Fernando Bronet; Juan A Garcia-Velasco Journal: Reprod Biol Endocrinol Date: 2021-12-14 Impact factor: 5.211
Authors: Nicola Tempest; Madeleine France-Ratcliffe; Hannan Al-Lamee; Evie R Oliver; Emily E Slaine; Andrew J Drakeley; Victoria S Sprung; Dharani K Hapangama Journal: Reprod Fertil Date: 2022-09-01