title: Effect of body mass index on in vitro fertilization outcomes in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  The objective of the investigation was to study the effect of body mass index (BMI) on in vitro fertilization (IVF) outcomes within a polycystic ovary syndrome (PCOS) population.
  
  
  METHODS
  This was a retrospective cohort study including 101 cycles from 79 women younger than 40 years old with a clinically documented diagnosis of PCOS by Rotterdam criteria undergoing IVF at a university-based infertility clinic from 2001 through 2010. All participants were stratified by BMI calculated from height and weight recorded within 3 months of cycle start: lean (18.7-24.9 kg/m(2), n = 51), overweight (25-29.9 kg/m(2), n = 19), and obese (≥30 kg/m(2), n = 31). Linear, logistic, and Poisson regressions were used as appropriate to estimate the effect of a range of BMIs on IVF outcomes while adjusting for potential confounders.
  
  
  RESULTS
  Obese PCOS women had 69% lower odds of clinical pregnancy per cycle start (odds ratio [OR], 0.31; 95% confidence interval [CI], 0.11-0.86; P = .02) and 77% lower odds of clinical pregnancy per embryo transfer (OR, 0.23; 95% CI, -0.08 to 0.68; P = .008) compared with lean PCOS women. Among obese PCOS women, the odds of live birth were 71% lower per cycle start (OR, 0.29; 95% CI, 0.10-0.84; P = .02) and 77% lower per embryo transfer (OR, 0.23; 95% CI, 0.07-0.71; P = .01) compared with lean PCOS women. There was a trend toward decreased ovarian hyperstimulation syndrome incidence with increasing BMI among women with PCOS: 19.6% in lean, 10.5% in overweight, and 3.2% in obese.
  
  
  CONCLUSIONS
  PCOS is a broad syndrome, with our results demonstrating 2 distinct populations, lean and obese, which have different IVF outcomes including ovarian hyperstimulation syndrome risk profiles. This information is important for clinicians because it informs treatment decisions.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Electronic address: ameliabailey@gmail.com.
authors.forename: Amelia P
authors.initials: AP
authors.lastname: Bailey
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Leah K
authors.initials: LK
authors.lastname: Hawkins
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Biostatistics, Harvard School of Public Health, Boston, MA.
authors.forename: Katharine F
authors.initials: KF
authors.lastname: Correia
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Elena H
authors.initials: EH
authors.lastname: Yanushpolsky
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016014:Linear Models; D050498:Live Birth / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology; D054315:Oocyte Retrieval / Q000706:statistics & numerical data; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055815:Young Adult
keywords: assisted reproduction; body mass index; in vitro fertilization; polycystic ovary syndrome; weight