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Obesity results with smaller oocyte in in vitro fertilization/intracytoplasmic sperm injection cycles—a prospective study

  • Gamete Biology
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Background

Obesity is associated with several fertility disorders. This prospective cohort study was designed to evaluate the effect of body mass index (BMI) (kg/m2) on oocyte diameter and treatment.

Methods

Women undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) were enrolled in the study. They were divided into two groups according to BMI: obese (BMI > 30) and normal weight (BMI < 25). Mature oocytes were evaluated according to total diameter, zona pellucida, and oolema diameters.

Results

A total of 387 oocytes were obtained from the 46 women who participated. Significantly more mature oocytes (M2) were retrieved from normal weight patients compare to obese women (15.1 ± 6.8 vs. 9.7 ± 3.9, respectively, P < 0.001). Oocytes from women in the obese group were significantly smaller than those in the normal weight group, including oocyte diameter (157.9 ± 7.9 vs. 164.3 ± 5.1 μm, P < 0.0001), oolema diameter (110.3 ± 4.5 vs. 113.5 ± 3.5 μm, P < 0.0001), and zona pellucida thickness (17.9 ± 2.6 vs. 19.0 ± 2.4 μm, P < 0.000), respectively. Multivariate logistic regression analysis, including oolema diameter, female age, BMI, number of M2 oocytes, and zona pellucida, was conducted to predict pregnancy. Small oolema diameter in obese patient adversely correlated with pregnancy. Larger oolema diameter was positively associated with the probability of pregnancy in the obese group as well as thinner zona pellucida.

Conclusion

Obesity is associated with smaller oocytes, which adversely affect fertility outcomes.

Trial registration

NIH number NCT01672931

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References

  1. Losing weight, body mass index [Internet]. Available from: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_dis.htm

  2. WHO | Obesity and overweight. WHO. World Health Organization; 2016.

  3. Practice Committee of American Society for Reproductive Medicine. Obesity and reproduction: an educational bulletin. Fertil Steril. 2008;90:S21–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19007633

    Google Scholar 

  4. Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol. 2015;29:498–506. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25619586

    Article  PubMed  Google Scholar 

  5. Rittenberg V, Seshadri S, Sunkara SK, Sobaleva S, Oteng-Ntim E, El-Toukhy T. Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis. Reprod BioMed Online. 2011;23:421–39.

    Article  PubMed  Google Scholar 

  6. MacHtinger R, Combelles CMH, Missmer SA, Correia KF, Fox JH, Racowsky C. The association between severe obesity and characteristics of failed fertilized oocytes. Hum Reprod. 2012;27:3198–207.

    Article  CAS  PubMed  Google Scholar 

  7. Jungheim ES, Schoeller EL, Marquard KL, Louden ED, Schaffer JE, Moley KH. Diet-induced obesity model: abnormal oocytes and persistent growth abnormalities in the offspring. Endocrinology. 2010;151:4039–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Comstock IA, Diaz-Gimeno P, Cabanillas S, Bellver J, Sebastian-Leon P, Shah M, et al. Does an increased body mass index affect endometrial gene expression patterns in infertile patients? A functional genomics analysis. Clin. Trial Regist. Number NCT02205866.Fertil Steril Ò. 2016.

  9. Bellver J, Ayllon Y, Ferrando M, Melo M, Goyri E, Pellicer A, et al. Female obesity impairs in vitro fertilization outcome without affecting embryo quality. Fertil Steril. 2010;93:447–54.

    Article  PubMed  Google Scholar 

  10. van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2015.

  11. Norman RJ, Noakes M, Wu R, Davies MJ, Moran L, Wang JX. Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update. 2004;10:267–80.

    Article  PubMed  Google Scholar 

  12. Luke B, Brown MB, Stern JE, Missmer SA, Fujimoto VY, Leach R. Female obesity adversely affects assisted reproductive technology (ART) pregnancy and live birth rates. Hum Reprod. 2011;26:245–52.

    Article  PubMed  Google Scholar 

  13. Marquard KL, Stephens SM, Jungheim ES, Ratts VS, Odem RR, Lanzendorf S, et al. Polycystic ovary syndrome and maternal obesity affect oocyte size in in vitro fertilization/intracytoplasmic sperm injection cycles. Fertil Steril. 2011;95:2146–2149.e1. doi:10.1016/j.fertnstert.2010.10.026.

    Article  PubMed  Google Scholar 

  14. Leary C, Leese HJ, Sturmey RG. Human embryos from overweight and obese women display phenotypic and metabolic abnormalities. Hum Reprod. 2015;30:122–32.

    Article  PubMed  Google Scholar 

  15. Macklon NS, Stouffer RL, Giudice LC, Fauser BCJM. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev. 2006;27:170–207.

    Article  PubMed  Google Scholar 

  16. Payne D, Flaherty SP, Jeffrey R, Warnes GM, Matthews CD. Successful treatment of severe male factor infertility in 100 consecutive cycles using intracytoplasmic sperm injection. Hum Reprod. 1994;9:2051–7.

    Article  CAS  PubMed  Google Scholar 

  17. Racowsky C, Stern JE, Gibbons WE, Behr B, Pomeroy KO, Biggers JD. National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril. 2011;95:1985–9. doi:10.1016/j.fertnstert.2011.02.009.

    Article  PubMed  Google Scholar 

  18. Cummins JM, Breen TM, Harrison KL, Shaw JM, Wilson LM, Hennessey JF. A formula for scoring human embryo growth rates in in vitro fertilization: its value in predicting pregnancy and in comparison with visual estimates of embryo quality. J In Vitro Fert Embryo Transf. 1986;3:284–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3783014

    Article  CAS  PubMed  Google Scholar 

  19. Balaban B, Brison D, Calderón G, Catt J, Conaghan J, Cowan L, et al. Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Reprod Biomed. 2011;22:632–46. doi:10.1016/j.rbmo.2011.02.001.

    Article  Google Scholar 

  20. Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turkish Ger Gynecol Assoc. 2015;16:111–7. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4456969&tool=pmcentrez&rendertype=abstract

    Article  Google Scholar 

  21. Maheshwari A, Stofberg L, Bhattacharya S. Effect of overweight and obesity on assisted reproductive technology—a systematic review. Hum Reprod Update. 2007;13:433–44.

    Article  CAS  PubMed  Google Scholar 

  22. Purcell SH, Moley KH. The impact of obesity on egg quality. J Assist Reprod Genet. 2011;28:517–24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21625966

    Article  PubMed  PubMed Central  Google Scholar 

  23. Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity’s impact. 2017.

  24. Robker RL, Akison LK, Bennett BD, Thrupp PN, Chura LR, Russell DL, et al. Obese women exhibit differences in ovarian metabolites, hormones, and gene expression compared with moderate-weight women. J Clin Endocrinol Metab. 2009;94:1533–40.

    Article  CAS  PubMed  Google Scholar 

  25. Metwally M, Cutting R, Tipton A, Skull J, Ledger WL, Li TC. Effect of increased body mass index on oocyte and embryo quality in IVF patients. Reprod BioMed Online. 2007;15:532–8.

    Article  CAS  PubMed  Google Scholar 

  26. Lazzaroni-Tealdi E, Barad DH, Albertini DF, Yu Y, Kushnir VA, Russell H, et al. Oocyte scoring enhances embryo-scoring in predicting pregnancy chances with IVF where it counts most. PLoS One. 2015;10:1–13.

    Article  Google Scholar 

  27. Nichols JE, Crane MM IV, Higdon HL, Miller PB, Boone WR. Extremes of body mass index reduce in vitro fertilization pregnancy rates. Fertil Steril. 2003;79:645–7.

    Article  PubMed  Google Scholar 

  28. Seif MW, Diamond K, Nickkho-Amiry M. Obesity and menstrual disorders. Best Pract. Res. Clin. Obstet. Gynaecol. 2015;29:516–27. doi:10.1016/j.bpobgyn.2014.10.010.

    Article  PubMed  Google Scholar 

  29. Rienzi L, Vajta G, Ubaldi F. Predictive value of oocyte morphology in human IVF: a systematic review of the literature. Hum Reprod Update. 2011;17:34–45. Available from: http://humupd.oxfordjournals.org/cgi/doi/10.1093/humupd/dmq029

    Article  PubMed  Google Scholar 

  30. Ebner T, Moser M, Tews G. Is oocyte morphology prognostic of embryo developmental potential after ICSI? Reprod BioMed Online. 2006;12:507–12.

    Article  PubMed  Google Scholar 

  31. Salata RG, Araujo MCPM, de Melo AS, de Albuquerque Salles Navarro PA, Ferriani RA, dos Reis RM. Oocyte diameter as a predictor of fertilization and embryo quality in assisted reproduction cycles. Fertil Steril. 2010;93:621–5.

    Article  Google Scholar 

  32. Sun YP, Xu Y, Cao T, Su YC, Guo YH. Zona pellucida thickness and clinical pregnancy outcome following in vitro fertilization. Int J Gynaecol Obstet. 2005;89:258–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15919392

    Article  CAS  PubMed  Google Scholar 

  33. Balakier H, Sojecki A, Motamedi G, Bashar S, Mandel R, Librach C. Is the zona pellucida thickness of human embryos influenced by women’s age and hormonal levels? Fertil Steril. 2012;98:77–83. doi:10.1016/j.fertnstert.2012.04.015.

    Article  CAS  PubMed  Google Scholar 

  34. Wittemer C, Ohl J, Bailly M, Bettahar-Lebugle K, Nisand I. Does body mass index of infertile women have an impact on IVF procedure and outcome? J Assist Reprod Genet. 2000;17:547–52. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3455453&tool=pmcentrez&rendertype=abstract

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Shah DK, Missmer SA, Berry KF, Racowsky C, Ginsburg ES. Effect of obesity on oocyte and embryo quality in women undergoing in vitro fertilization. Obstet Gynecol. 2011;118:63–70.

    Article  PubMed  Google Scholar 

  36. Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015;16:621–38. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26016557

    Article  CAS  PubMed  Google Scholar 

  37. Salihu HM, De La Cruz C, Rahman S, August EM. Does maternal obesity cause preeclampsia? A systematic review of the evidence. Minerva Ginecol. 2012;64:259–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22728572

    CAS  PubMed  Google Scholar 

  38. Carmichael SL, Rasmussen SA, Shaw GM. Prepregnancy obesity: a complex risk factor for selected birth defects. Birth Defects Res A Clin Mol Teratol. 2010;88:804–10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20973050

    Article  CAS  PubMed  Google Scholar 

  39. Radulescu L, Munteanu O, Popa F, Cirstoiu M. The implications and consequences of maternal obesity on fetal intrauterine growth restriction. J Med Life. 2013;6:292–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24155784

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM. Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes. Am J Obstet Gynecol. 2003;189:1726–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14710105

    Article  PubMed  Google Scholar 

  41. Consultation W. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Heal Organ - Tech Rep Ser. 2000;894:i–xii. 1-253

    Google Scholar 

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Authors and Affiliations

  1. IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Ruth and Bruce Rappaport School of Medicine, The Technion – Israel Institute of Technology, Haifa, Israel

    Yuval Atzmon, Ester Shoshan-Karchovsky, Medeia Michaeli, Nardin Aslih, Guy Shrem, Adrian Ellenbogen & Einat Shalom-Paz

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  1. Yuval Atzmon
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Correspondence to Einat Shalom-Paz.

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Atzmon, Y., Shoshan-Karchovsky, E., Michaeli, M. et al. Obesity results with smaller oocyte in in vitro fertilization/intracytoplasmic sperm injection cycles—a prospective study. J Assist Reprod Genet 34, 1145–1151 (2017). https://doi.org/10.1007/s10815-017-0975-6

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  • DOI: https://doi.org/10.1007/s10815-017-0975-6

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