The impact of body mass index on laboratory, clinical outcomes and treatment costs in assisted reproduction: a retrospective cohort study
Victória Campos Dornelles, Marta Ribeiro Hentschke, Mariangela Badalotti, Isadora Badalotti Telöken, Vanessa Devens Trindade, Bibiana Cunegatto, Natália Fontoura Vasconcelos, Bartira Ercília Pinheiro da Costa, Álvaro Petracco, Alexandre Vontobel Padoin
Abstract
BACKGROUND: The aim of this study was to evaluate the influence of the body mass index (BMI) on laboratory, clinical outcomes and treatment costs of assisted reproduction, as there are still controversial and inconclusive studies on this subject. METHODS: ): Group 1 < 25; Group 2, 25-29.9 and Group 3, ≥ 30. A total of 1753 in vitro fertilization (IVF) fresh embryo transfer (ET) cycles were included for assisted reproduction outcomes analysis and 1869 IVF-ET plus frozen embryo transfer (FET) for cumulative pregnancy analysis. RESULTS: As higher the BMI, higher was the proportion of canceled IVF cycles (G1 (6.9%) vs. G2 (7.8%) vs. G3 (10.4%), p = 0.002) and gonadotropin's total dose (IU) and treatment costs (G1 (1685 ± 595, U$ 683,02) vs. G2 (1779 ± 610, U$ 721,13) vs. G3 (1805 ± 563, U$ 764,09), p = 0.001). A greater number of mature oocytes was observed in G1 and G2 (6 [6.4-7.0] vs. 6 [5.6-6.6] vs. 4 [4.6-6.7], p = 0.011), which was not found in oocyte maturity rate (p = 0.877). A significant linear tendency (p = 0.042) was found in cumulative pregnancy rates, pointing to worse clinical outcomes in overweight and obese patients. CONCLUSION: These findings highlight the importance of considering the higher treatment costs for these patients, beyond all the well-known risks regarding weight excess, fertility, and pregnancy, before starting IVF treatments.