title: The effect of body mass index on the outcomes of first assisted reproductive technology cycles.
abstract: OBJECTIVE
  To provide assisted reproductive technology (ART) outcome rates per body mass index (BMI) category after controlling for potential confounders.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Large university-affiliated infertility practice.
  
  
  METHODS
  Women undergoing ART.
  
  
  METHODS
  None.
  
  
  METHODS
  The primary outcome was live birth. Analyses were stratified according to BMI category and adjusted for potential confounders, including maternal and paternal age, baseline serum FSH, duration of gonadotropin stimulation, mean daily gonadotropin dose, peak serum E(2), number of oocytes retrieved, use of intracytoplasmic sperm injection, embryo quality and number, transfer day, and number of embryos transferred.
  
  
  RESULTS
  We analyzed the first autologous fresh IVF or IVF-ICSI cycle of 4,609 patients. There were no differences in the rates of cycle cancellation, spontaneous abortion, biochemical and ectopic pregnancies, or multiple births. After adjusting for potential confounders, patients with BMI ≥ 30.0 kg/m(2) had significantly decreased odds of implantation, clinical pregnancy, and live birth. The adjusted odds ratio (95% confidence interval [CI]) of live birth were 0.63 (0.47-0.85) for BMI 30.00-34.99, 0.39 (0.25-0.61) for BMI 35.00-39.99, and 0.32 (0.16-0.64) for BMI ≥ 40.0 compared with normal-weight cohorts.
  
  
  CONCLUSIONS
  Obesity has a significant negative effect on ART outcomes. Patients with BMI > 30 kg/m(2) have up to 68% lower odds of having a live birth following their first ART cycle compared with women with BMI < 30.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. vmoragia@bidmc.harvard.edu
authors.forename: Vasiliki A
authors.initials: VA
authors.lastname: Moragianni
authors.forename: Stephanie-Marie L
authors.initials: SM
authors.lastname: Jones
authors.forename: David A
authors.initials: DA
authors.lastname: Ryley
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D011379:Prognosis; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome