Effect of body mass index on the outcomes of controlled ovarian hyperstimulation in Chinese women with polycystic ovary syndrome: a multicenter, prospective, observational study.
OBJECTIVE
The purpose of the present study is to explore the influence of body mass index (BMI) on outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) techniques in Chinese women with polycystic ovary syndrome (PCOS).


METHODS
This was a multicenter, prospective, observational study that enrolled 800 subjects with PCOS from nine hospitals in China. Patients were categorized according to BMI categories: underweight, <18.5 kg/m2; normal, 19-23.9 kg/m2; overweight, 24-27.9 kg/m2; and obese, ≥28 kg/m2. Total recombinant follicle-stimulating hormone (rFSH) dose used, estradiol, and progesterone levels on human chorionic gonadotropin (hCG) day; implantation rate; and biochemical, clinical, and ongoing pregnancy rates were compared among BMI categories. Hormone levels (estradiol, follicle-stimulating hormone (FSH), LH, testosterone, and progesterone) were measured using electrochemiluminescence assays.


RESULTS
Among the 774 subjects, 27.3 % were overweight and 8.1 % were obese. The rFSH dose used differed significantly among BMI categories (P < 0.001). The implantation rate was lower in obese subjects than that in normal-weight subjects (25.3 vs 45.7 %). Clinical pregnancy rate per transfer differed among BMI categories (P = 0.033), but there was no difference for biochemical (P = 0.327) and ongoing (P = 0.084) pregnancy rates. The miscarriage rate was similar among BMI categories.


CONCLUSIONS
More than one third of Chinese women with PCOS undergoing IVF/ICSI are overweight or obese. Elevated BMI is associated with reduced clinical pregnancy rate but similar ongoing pregnancy rates, suggesting that BMI has little impact on IVF outcomes.
Center for Reproductive Medicine, Shandong University, Jinan, China.
Yan
Y
Sheng
Reproductive & Genetic Hospital CITIC-Xiangya, Changsha, China.
Guangxiu
G
Lu
Jiangsu Province Hospital, Nanjing, China.
Jiayin
J
Liu
The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Xiaoyan
X
Liang
The First People's Hospital of Yunnan Province, Kunming, China.
Yanping
Y
Ma
The First Hospital of Lanzhou University, Lanzhou, China.
Xuehong
X
Zhang
Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Songying
S
Zhang
The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yingpu
Y
Sun
Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Yun
Y
Sun
Merck Serono Co., Ltd, Beijing, China.
Wenfeng
W
Chen
Merck Serono Co., Ltd, Beijing, China.
Wenhui
W
Fang
Center for Reproductive Medicine, Shandong University, Jinan, China. chenzijiang@hotmail.com.
Zijiang
Z
Chen
D000022:Abortion, Spontaneous / Q000503:physiopathology; D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D002681:China; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D016471:Ovarian Hyperstimulation Syndrome / Q000503:physiopathology; D050177:Overweight / Q000150:complications / Q000503:physiopathology*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods
Body mass index; In vitro fertilization; Intracytoplasmic sperm injections; Polycystic ovary syndrome; Pregnancy rate