Obesity And Poor Reproductive Outcome: The Potential Role Of The Endometrium
Jose Bellver, M.D., Marco A. B. Melo, M.D., Ernesto Bosch, M.D., Vicente Serra, M.D., Jose Remohı, M.D., And Antonio Pellicer, M.D. Departments Of Reproduction And Maternal–Fetal Medicine, Instituto Valenciano De Infertilidad, Universidad De Valencia, Valencia, Spain
Objective: To analyze the potential role of extraovarian factors such as endometrium in the reproductive outcomeof obese patients.
Design: Retrospective study.
Setting: University-affiliated infertility clinic, between January 2001 and July 2005.
Patient(s): Women undergoing a total of 2656 first ovum donation (OD) cycles with good quality embryos.
Intervention(s): The oocyte donors underwent controlled ovarian hyperstimulation, and recipients received a wellestablished hormonal replacement therapy for endometrial preparation. In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was performed according to semen characteristics. All first cycles (n ¼ 2656) of ovum donation used good quality embryos and were divided into groups according to body mass index: <20 kg/m2 (n ¼ 471), 20 to 24.9 kg/m2 (n ¼ 1613), 25 to 29.9 kg/m2 (n ¼ 450), and R30 kg/m2 (n ¼ 122).
Main Outcome Measure(s): The recipient body mass index groups were compared regarding IVF outcome.
Result(s): The rates of implantation, pregnancy, miscarriage, and ongoing pregnancy were similar among the body mass index groups, although there was a negative trend when body mass index increased. Ongoing pregnancy rates per cycle were poorer in the overweight and obese groups than in the underweight and normal groups. In addition, women under 25 kg/m2 presented an ongoing pregnancy rate per cycle of 45.5%, compared with 38.3% for those with R25 kg/m2.
Conclusion(s): Excess weight exerts an extraovarian detrimental effect. The role of the endometrium or its environment seems to be subtle but should be taken into account. (Fertil Steril 2007;88:446–51.2007 by American Society for Reproductive Medicine.)
