Effect of weight status on pregnancy outcome in intra cytoplasmic sperm injection

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.
Materials and 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/m²), normal weight, (BMI 18-22.9 kg/m²) overweight (BMI 23-25.9 kg/m²) and obese (BMI ≥26 kg/m²). 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/m² had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI ≥26 kg/m².
Conclusion: A BMI cut off value of above 26 kg/m² in our study population is associated with a negative impact on pregnancy outcome.

Keywords
Intracytoplasmic sperm injection; Body mass index; Controlled ovarian stimulation; Gonadotrophin -releasing hormone agonists; Embryo transfer