title: Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry.
abstract: OBJECTIVE
  To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A total of 239,127 fresh IVF cycles from the 2008-2010 Society for Assisted Reproductive Technology registry were stratified into cohorts based on World Health Organization BMI guidelines. Cycles reporting normal BMI (18.5-24.9 kg/m(2)) were used as the reference group (REF). Subanalyses were performed on cycles reporting purely polycystic ovary syndrome (PCOS)-related infertility and those with purely male-factor infertility (34,137 and 89,354 cycles, respectively).
  
  
  METHODS
  None.
  
  
  METHODS
  Implantation rate, clinical pregnancy rate, pregnancy loss rate, and live birth rate.
  
  
  RESULTS
  Success rates and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for all pregnancy outcomes were most favorable in cohorts with low and normal BMIs and progressively worsened as BMI increased. Obesity also had a negative impact on IVF outcomes in cycles performed for PCOS and male-factor infertility, although it did not always reach statistical significance.
  
  
  CONCLUSIONS
  Success rates in fresh autologous cycles, including those done for specifically PCOS or male-factor infertility, are highest in those with low and normal BMIs. Furthermore, there is a progressive and statistically significant worsening of outcomes in groups with higher BMIs. More research is needed to determine the causes and extent of the influence of BMI on IVF success rates in other patient populations.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.
authors.forename: Meredith P
authors.initials: MP
authors.lastname: Provost
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Acharya
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Chaitanya R
authors.initials: CR
authors.lastname: Acharya
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Yeh
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ryan G
authors.initials: RG
authors.lastname: Steward
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Eaton
authors.affiliation: University Hospitals Fertility Center, Beachwood, Ohio.
authors.forename: James M
authors.initials: JM
authors.lastname: Goldfarb
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Duke University Medical Center, Durham, North Carolina. Electronic address: muashersj@gmail.com.
authors.forename: Suheil J
authors.initials: SJ
authors.lastname: Muasher
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D015992:Body Mass Index; D010064:Embryo Implantation; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007248:Infertility, Male / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000150:complications; D011247:Pregnancy; D018873:Pregnancy Rate; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D016896:Treatment Outcome
keywords: ART; BMI; IVF; Obesity