title: Effect of weight status on pregnancy outcome in intra cytoplasmic sperm injection.
abstract: BACKGROUND
  There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI). The knowledge of impact of body mass index (BMI) on reproductive outcome can help to counsel these patients.
  
  
  OBJECTIVE
  To compare reproductive outcome in females of different BMI after ICSI.
  
  
  METHODS
  Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, (BMI <18 kg/m(2)), normal weight, (BMI 18-22.9 kg/m(2)) overweight (BMI 23-25.9 kg/m(2)) and obese (BMI ≥26 kg/m(2)). The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA (analysis of variance). Pregnancy outcome of these was categorized as; no conception βhCG <5 m IU/ml, preclinical abortion with βhCG >5 m IU/ml, no cardiac activity on trans vaginal scan (TVS) and clinical pregnancy with βhCG >5mIU/ml and cardiac activity on trans vaginal scan.
  
  
  RESULTS
  Females with BMI 23-25.99 kg/m(2) had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI ≥26 kg/m(2).
  
  
  CONCLUSIONS
  A BMI cut off value of above 26 kg/m(2) in our study population is associated with a negative impact on pregnancy outcome.
authors.affiliation: Department of Physiology, Bahria University Medical and Dental College, Karachi, Pakistan. ; Department of Physiology, University of Karachi, Karachi, Pakistan.
authors.forename: Rehana
authors.initials: R
authors.lastname: Rehman
authors.affiliation: Department of Physiology, Umm Al-Qura University, Makkah, Kingdom Saudia Arabia. ; Department of Physiology, University of Karachi, Karachi, Pakistan. ; Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
authors.forename: Zahir
authors.initials: Z
authors.lastname: Hussain
authors.affiliation: Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
authors.forename: Syeda Sadia
authors.initials: SS
authors.lastname: Fatima
keywords: Body mass index; Controlled ovarian stimulation; Embryo transfer.; Gonadotrophin -releasing hormone agonists; Intracytoplasmic sperm injection