Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome

被引:108
作者
Jungheim, Emily S. [1 ]
Lanzendorf, Susan E. [1 ]
Odem, Randall R. [1 ]
Moley, Kelle H. [1 ]
Chang, Aimee S. [1 ]
Ratts, Valerie S. [1 ]
机构
[1] Washington Univ, Dept Obstet & Gynecol, Div Reprod Endocrinol & Infertil, St Louis, MO 63108 USA
关键词
Morbid obesity; polycystic ovary syndrome; pregnancy; IVF; BODY-MASS INDEX; WEIGHT-LOSS; SURGERY;
D O I
10.1016/j.fertnstert.2008.04.063
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine whether morbid obesity is associated with decreased pregnancy and live birth rates after IVF in women with polycystic ovary syndrome (PCOS). Design: Retrospective cohort study. Setting: University-based fertility center. Patient(s): Seventy-two women with PCOS who completed their first IVF cycle between 2001 and 2006. Intervention(s): Outcomes of IVF were compared between women with a body mass index (BMI) of <40 kg/m(2) vs. those with a BMI of >= 40 kg/m(2). Main Outcome Measure(s): Clinical pregnancy rate, live birth rate. Result(s): Morbidly obese women with PCOS (n = 19) had significantly lower clinical pregnancy rates after IVF than patients with PCOS who were not morbidly obese (n = 53) (32% vs. 72%, relative risk 0.44, 95% confidence interval 0.22-0.87). Their live birth rates were lower too, although this difference was not statistically significant (32% vs. 60%, relative risk 0.52, 95% confidence interval 0.26-1.05). Conclusion(s): Morbid obesity is associated with lower pregnancy rates in women with PCOS after IVF, raising the question of whether weight loss may improve IVF success rates for morbidly obese PCOS patients. (Fertil Steril (R) 2009;92:256-61. (C) 2009 by American Society for Reproductive Medicine.)
引用
收藏
页码:256 / 261
页数:6
相关论文
共 28 条
[1]   Long-term mortality after gastric bypass surgery [J].
Adams, Ted D. ;
Gress, Richard E. ;
Smith, Sherman C. ;
Halverson, R. Chad ;
Simper, Steven C. ;
Rosamond, Wayne D. ;
LaMonte, Michael J. ;
Stroup, Antoinette M. ;
Hunt, Steven C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (08) :753-761
[2]   Human embryo fragmentation in vitro and its implications for pregnancy and implantation [J].
Alikani, M ;
Cohen, J ;
Tomkin, G ;
Garrisi, GJ ;
Mack, C ;
Scott, RT .
FERTILITY AND STERILITY, 1999, 71 (05) :836-842
[3]  
ALIKANI M., 2007, The origins and consequences of fragmentation in mammalian eggs and embryos
[4]  
Balen Adam H, 2007, Hum Fertil (Camb), V10, P195, DOI 10.1080/14647270701731290
[5]   Obesity and poor reproductive outcome:: the potential role of the endometrium [J].
Bellver, Jose ;
Melo, Marco A. B. ;
Bosch, Ernesto ;
Serra, Vicente ;
Remohi, Jose ;
Pellicer, Antonio .
FERTILITY AND STERILITY, 2007, 88 (02) :446-451
[6]  
Carrell Douglas T, 2001, Reprod Biomed Online, V3, P109
[7]   Management of obesity in pregnancy [J].
Catalano, Patrick M. .
OBSTETRICS AND GYNECOLOGY, 2007, 109 (02) :419-433
[8]   Bioavailability of hCG after intramuscular or subcutaneous injection in obese and non-obese women [J].
Chan, CCW ;
Ng, EHY ;
Chan, MMY ;
Tang, OS ;
Lau, EYL ;
Yeung, WSB ;
Ho, PC .
HUMAN REPRODUCTION, 2003, 18 (11) :2294-2297
[9]   Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome [J].
Chang, J ;
Azziz, R ;
Legro, R ;
Dewailly, D ;
Franks, S ;
Tarlatzis, BC ;
Fauser, B ;
Balen, A ;
Bouchard, P ;
Dahlgren, E ;
Devoto, L ;
Diamanti, E ;
Dunaif, A ;
Filicori, M ;
Homburg, R ;
Ibanez, L ;
Laven, J ;
Magoffin, D ;
Nestler, J ;
Norman, RJ ;
Pasquali, R ;
Pugeat, M ;
Strauss, J ;
Tan, S ;
Taylor, A ;
Wild, R ;
Wild, S ;
Ehrmann, D ;
Lobo, R .
FERTILITY AND STERILITY, 2004, 81 (01) :19-25
[10]   Obesity does not adversely affect results in patients who are undergoing in vitro fertilization and embryo transfer [J].
Dechaud, Herve ;
Anahory, Tal ;
Reyftmann, Lionel ;
Loup, Vanessa ;
Hamamah, Samir ;
Hedon, Bernard .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2006, 127 (01) :88-93