Effect of women’s Obesity on the outcome of In Vitro Fertilization (Comparative study)

Background: Obesity is a major problem of public health, intervenes at different levels on the reproductive function such as: increase conception time and decreased fecundity.   
Aim of the Work: to assess the impact of women’s obesity on the outcome of ICSI and embryo transfer by measuring the number of clinical pregnancies in groups of patients with different BMI, also by measuring total FSH dose required for follicular stimulation, The duration required for stimulation, Serum estradiol level on the day of hCG administration, number of oocytes collected, number of normally fertilized oocytes, fertilization rate, positive serum β-hCG rate, ongoing pregnancy rate.
Patients and Methods: Retrospective comparative cohort study, conducted in IVF unit in maternity hospital of Ain Shams university, from January 2016 to December 2021, all the patients underwent ICSI and embryo transfer in the given period their record will be revised and included regardless sample size. With at least 132 patients will be enrolled divided into 3 groups: normal weight patients with BMI from 18.5kg/m2 to 24.9 kg/m2, overweight patients with BMI from 25kg/m2 to 29.9 kg/m2, and obese patients with BMI ≥ 30kg/m2.
Results: The starting dose of FSH showed no significant differences (p=0.240), and likewise, the total dose exhibited no significant variations (p=0.370). However, certain trends emerged. Group C had a slightly longer duration of stimulation (p=0.091), potentially indicating a more robust approach, notably, the number of oocytes collected significantly differed among the groups (p=0.019*), with Group A having the highest mean count (13.17±8.28), followed by Group B (11.05±6.78), and then Group C (9.48±6.37). This disparity might imply differences in ovarian response or treatment effectiveness. The number of oocytes fertilized did not significantly differ (p=0.630).  
Conclusions: The comprehensive analysis of demographic and fertility-related parameters across three distinct groups (Group A, Group B, and Group C) undergoing in vitro fertilization (IVF) treatment reveals that there are statistically significant differences in the ovarian response to the stimulation in the form of the duration and the number of oocytes retrieval, while in the in most of the measured variables there is no statistically significant difference. These include age, parity, infertility status, hormone levels, antral follicle counts, type and dosage of follicle-stimulating hormone (FSH), and numerous IVF outcome measures such as the number of good quality embryos, embryos obtained, fresh transferred embryos, biochemical and clinical pregnancy test results, and live birth outcomes. These findings suggest that, on average, the studied groups exhibit comparable demographic characteristics, ovarian function, and IVF treatment outcomes, highlighting the consistency in various aspects of IVF protocols and reproductive outcomes among these groups.