Which spermatozoon should be eliminated in ICSI? (original) (raw)
Related papers
JBRA Assisted Reproduction, 2015
Objective: A high body mass index (BMI) has been shown to associate with negative reproductive outcomes. Women with high BMI have in general lower chances of getting pregnant as well as higher risk of pregnancy complications. Several studies have described in the past the relationship between high BMI and the pregnancy outcome, however, some of them have a small sample size or fail to control for variables associated with a diminished probability of pregnancy. In the present study, we aim to analyze the role of the BMI of all parties involved in oocyte donation cycles (that is: the oocyte donor, the recipient woman, and the male partner) on pregnancy outcomes. Methods: This study includes 1092 oocyte donation cycles. Inclusion criteria were: fertilization by ICSI, frozen semen, transfer of 2 embryos at day 3 of in vitro development. For statistical analysis, BMI was divided in: low weight (<20 kg/m2), normal (20-24 kg/m2), overweight (25-29 kg/m2) and obesity (≥30 kg/m2). Quantitative and categorical variables were assessed by squared-Chi test and one-way ANOVA. The association between the BMI (recipient, oocyte donor and partner) and pregnancy rate was assessed by multivariate logistic regression. Results: Laboratory outcomes and pregnancy rates do not differ among the different BMI categories of recipient, oocyte donor or partner. After adjusted analyses (for oocyte donor age, for laboratory outcomes and for age and BMI of all the parties for pregnancy outcomes), no difference was found either. Conclusion: In oocyte donation cycles, where donors BMI is by law mandated to be in the 18-30 range, the pregnancy rate of the oocyte recipient does not seem to be affected by the BMI of any of the parties involved.
Body Mass Index Impacts In Vitro Fertilization Stimulation
ISRN Obstetrics and Gynecology, 2011
The objective of the study was to prospectively determine if body mass index (BMI) is predictive of live birth rates in patients undergoing IVF. The prospective study enrolled 117 infertility patients with the primary outcome measure being IVF success rates. Mean BMI did not differ between patients with successful outcomes and those without successful outcomes. There was a significant positive correlation between BMI and the number of stimulated follicles (r = 0.19, P < .05). A significant negative correlation between BMI and ampules of gonadotropins used (r = −0.25, P < .01) and between BMI and days of stimulation (r = −0.19, P < .05) was noted. These data demonstrate that women with an elevated BMI produce more follicles, stimulate quicker, and require less gonadotropins during IVF. However, BMI did not have a significant effect on pregnancy outcome rates.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006
Objective: To examine the outcome of in vitro fertilization according to the body mass index of infertile patients. Study design: Between September 2003 and May 2005, 573 patients underwent 789 in vitro fertilization cycles or ICSI because of male factor, tubal factor, and unexplained infertility were retrospectively included from our IVF database. The patients were classified in four groups: BMI < 20 kg/m 2 (264 cycles), 20 BMI < 25 (394 cycles), 25 BMI < 30 (83 cycles), and BMI ! 30 (48 cycles). All patients had a long protocol for IVF with a combination of the GnRH agonist and recombinant FSH. Results: All parameters of ovarian response were comparable except the total required r-FSH dose. This dose was statistically higher in the group of BMI ! 30 compared to the other groups ( p = 0.0003). All parameters of IVF outcome were comparable, including the cancellation rate, the implantation rate, and pregnancy rates. Conclusion: Obese patients require a higher r-FSH dose to achieve follicular maturation than normal weight patients. Obesity does not affect negatively results of in vitro fertilization. #
Clinical Obstetrics, Gynecology and Reproductive Medicine
Background: Many studies have suggested that female obesity has an impact on oocyte quality, embryo quality, and endometrial maturation in couples undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). In contrast, there are few data on the management of intrauterine insemination (IUI) in obese women. The objectives of the present study were to evaluate the clinical pregnancy and live birth rates in IVF/ICSI and IUI for overweight or obese women and to determine positive or negative predictive factors for pregnancy. Method: We analyzed long GnRH agonist or GnRH antagonist protocols with FSH/hMG for IVF/ICSI, and FSH/hMG alone for IUI. We classified the women into three groups: normal weight, overweight, and obesity. The latter group was divided into two obesity subgroups: class 1 and class 2/3. We recorded data on the patients' demographic, stimulation cycles, embryo cultures, and ongoing pregnancies obtained. For IVF/ICSI and IUI, we performed a univariate analysis of factors that were predictive of pregnancy and then selected a number for inclusion in a multivariate analysis. Results: The study included 1153 IVF/ICSI cycles and 541 IUI cycles. The clinical pregnancy and live birth rates in IVF/ICSI did not vary as a function of the female BMI. In IUI, the clinical pregnancy and live birth rates were significantly higher among obese women (21.6% and 17.7%, respectively) than among women of normal weight (12.2% and 9.3%, respectively; p<0.05). In IVF/ICSI and IUI, we did not observe an association between the spontaneous miscarriage rate and the BMI. In a univariate analysis, several predictive factors were found for IVF/ICSI and IUI. However, in a multivariate analysis, pregnancy in IVF/ICSI was notably predicted by the number of embryos obtained (≥5), whereas the absence of pregnancy in IUI was notably predicted by a monofollicular response to ovarian stimulation (p<0.001 for both). Conclusions: Our study did not find differences in clinical pregnancy and live birth rates as a function of female BMI in IVF/ICSI, and even evidenced higher rates among obese women in IUI. Nevertheless, women should be encouraged to lose weight if allowed by the setting and their age; this may decrease the incidence of obstetric complications during assisted reproductive technology programs.
Journal of assisted reproduction and genetics, 2008
Objective To determine if elevated body mass index in young women with normal ovarian reserve was associated with poorer ovarian response, difficulty at embryo transfer, and lower clinical pregnancy rates. Materials and methods Retrospective study of 417 first, fresh in vitro fertilization cycles performed between October 2004 and December 2006. All women were under the age of 35 and had normal cycle day 3 follicle stimulating hormone and estradiol levels. Subjects were divided into groups by BMI: <18.5, 18.5-24.9, 25-29.9, ≥30. Results Cancellation rates, peak estradiol levels, and mean number of oocytes retrieved were similar in all groups. There was a trend toward increasing difficulty in visualizing the air bubble at time of embryo transfer and lower implantation rates at higher body mass indices. Clinical and ongoing pregnancy rates were similar among groups. Conclusion Obesity in young women does not adversely affect clinical pregnancy rates in patients treated with in vitro fertilization.
The influence of body mass index on in vitro fertilization outcome
International Journal of Gynecology & Obstetrics, 2009
Objective: To examine whether body mass index (BMI) influences the outcome of in vitro fertilization (IVF). Methods: We studied 516 IVF cycles, 438 undergone by nonobese (BMI ≤ 30) and 78 by obese (BMI N 30) women who all had an a priori favorable prognosis (age b 40 years and first, second, or third IVF cycle). Results: Pregnancy was achieved in 122 (27.9%) nonobese and 12 (15.4%) obese women. The obese women required significantly longer stimulation and more gonadotropin ampoules, and had lower peak estradiol levels and a significantly lower fertilization rate; obese poor responders had a significantly lower pregnancy rate than nonobese poor responders; and the prevalence of poor responders was significantly higher among obese than nonobese women (28.2% vs 16.9%, P b 0.04). Conclusion: While the likelihood of poor responders was increased among obese women, reasonable conception rates were achieved in nonobese poor responders, and were comparable to the rates in nonobese and obese normal responders.
Effect of Obesity on Oocyte and Embryo Quality in Women Undergoing In Vitro Fertilization
Obstetrics & Gynecology, 2011
To estimate the effect of body mass index (BMI) on oocyte and embryo parameters and cycle outcomes in women undergoing in vitro fertilization (IVF). METHODS: We evaluated a retrospective cohort of 1,721 women undergoing a first IVF cycle with fresh, autologous embryos between 2007 and 2010 in an academic infertility practice. Main outcome measures included number of mature and normally fertilized oocytes, embryo morphology, estradiol on the day of human chorionic gonadotropin administration, clinical pregnancy, spontaneous abortion, and live birth. We performed multivariable analyses, adjusting for potential confounders, including age at cycle start, infertility diagnosis, type of stimulation, total gonadotropin dose, use of intracytoplasmic sperm injection, and number of embryos transferred. RESULTS: Compared with women of normal BMI, women with class II (BMI 35-39.9) and III (BMI 40 or higher) obesity had fewer normally fertilized oocytes (9.3 compared with 7.6 and 7.7, P<.03) and lower estradiol levels (2,047 pg/mL compared with 1,498 and 1,361, P<.001) adjusting for age and despite similar numbers of mature oocytes. Odds of clinical pregnancy (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.31-0.82) and live birth (OR 0.51, 95% CI 0.29-0.87) were 50% lower in women with class III obesity as compared with women of normal BMI. CONCLUSION: Obesity was associated with fewer normally fertilized oocytes, lower estradiol levels, and lower pregnancy and live birth rates. Infertile women requiring IVF should be encouraged to maintain a normal weight during treatment.
Correlation of body mass index with outcome of in vitro fertilization in a developing country
Archives of Gynecology and Obstetrics, 2012
Aims and objective To correlate ovarian response to stimulation and IVF outcome according to the women's body mass index (BMI). Materials and methods Records of all patients who underwent IVF cycle in our institution from January 2008 to October 2010 were reviewed retrospectively. Three hundred and twenty-eight patients underwent 342 in vitro fertilization (IVF) cycles or intra-cytoplasmic sperm injection (ICSI) and were divided into four subgroups according to BMI; underweight, BMI \ 18.5; normal weight, 18.5-24.9; overweight, 25.0-29.9; and obese, [30.0. Results In our study, with increasing BMI negative co-relation was seen with clinical pregnancy rate (CPR) (P value = 0.040). Increased doses of gonadotropins were required with increase in patients BMI (P value = 0.045). In the present study, no difference was seen in the number of oocyte retrieved but a decreased fertilization and cleavage rate was seen with decreased number of cryopreserved embryos with increasing BMI. This study shows that poorer oocyte quality is seen with increasing BMI which results in reduced CPR. In our study no deleterious effect of low BMI was seen on IVF outcome and CPR. Conclusion Female obesity impairs IVF outcome potentially by impairing oocyte quality but does not affect ovarian response to stimulation.
Fertility and Sterility, 2005
To independently evaluate the effect of body mass index (BMI) on implantation, pregnancy, and incidence of spontaneous miscarriage using the donor oocyte recipient model. Design: Institutional Review Board-approved retrospective data analyses of donor oocyte cycles from 1999 to 2004. Setting: Private assisted reproductive technology (ART) center. Patient(s): Five hundred thirty-six first cycle recipients of donor oocytes. Intervention(s): Data were collected from the first cycle of each donor oocyte recipient included in the study. The body mass index (BMI) of each recipient was calculated using the formula weight (in kilograms)/height (in meters squared). Patients were divided into four groups based on BMI: underweight, normal, overweight, and obese. Pregnancy outcomes in each group were compared. Main Outcome Measure(s): Body mass index, implantation rate, pregnancy rate (PR), miscarriage rate. Result(s): There were no statistically significant differences in the implantation rates, ongoing PRs, or spontaneous abortion rates among patients in the four BMI groups. When further divided into those patients receiving blastocyst vs. day 3 transfers, there was still no effect of BMI on implantation rate, PR, or loss rate among the blastocyst or day 3 donor oocyte recipients. Conclusion(s): Body mass index has no adverse impact on implantation or reproductive outcome in donor oocyte recipients. Therefore, obesity does not appear to exert a negative effect on endometrial receptivity.
Reproductive BioMedicine Online, 2017
since 1986. Her main interests are reproduction, infertility, contraception, oocyte donation, and fertility preservation. She has authored a number of papers in peer-reviewed journals, and is a member of several national and international scientist societies in the field. KEY MESSAGE Obesity has a well-known deleterious effect on reproductive outcomes. No negative effect was observed on the outcomes of oocyte donation cycles with increased donor body mass index (BMI) (up to donor BMI ≤28 kg/m 2). To minimize the negative effect of obesity on these outcomes, this BMI limit should be considered.