Complications and outcome of assisted reproduction technologies in overweight and obese women

A. M H Koning, M. A Q Mutsaerts, W. K H Kuchenbecher, F. J. Broekmans, J. A. Land, B. W. Mol, A. Hoek

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

BACKGROUND: Based on a presumed negative impact of overweight and obesity on reproductive capacity and pregnancy outcome, some national guidelines and clinicians have argued that there should be an upper limit for a woman's BMI to access assisted reproductive technologies (ART). However, evidence on the risk of complications or expected success rate of ART in obese women is scarce. We therefore performed a systematic review on the subject. METHODS: We searched the literature for studies reporting on complications or success rates in overweight and obese women undergoing ART. Articles were scored on methodological quality. We calculated pooled odds ratios (ORs) to express the association between overweight and obesity on the one hand, and complications and success rates of ART on the other hand. We only pooled results if data were available per woman instead of per cycle or embryo transfer. RESULTS: We detected 14 studies that reported on the association between overweight and complications during or after ART, of which 6 reported on ovarian hyperstimulation syndrome (OHSS), 7 on multiple pregnancies and 6 on ectopic pregnancies. None of the individual studies found a positive association between overweight and ART complications. The pooled ORs for overweight versus normal weight for OHSS, multiple pregnancy and ectopic pregnancy were 1.0 [95% confidence interval (CI) 0.77-1.3], 0.97 (95% CI 0.91-1.04) and 0.96 (95% CI 0.54-1.7), respectively. In 27 studies that reported on BMI and the success of ART, the pooled ORs for overweight versus normal weight on live birth, ongoing and clinical pregnancy following ART were OR 0.90 (95% CI 0.82-1.0), 1.01 (95% CI 0.75-1.4) and OR 0.94 (95% CI 0.69-1.3), respectively. CONCLUSIONS: Data on complications following ART are scarce and therefore a registration system should be implemented in order to gain more insight into this subject. In the available literature, there is no evidence of overweight or obesity increasing the risk of complications following ART. Furthermore, they only marginally reduce the success rates. Based on the currently available data, overweight and obesity in itself should not be a reason to withhold ART.

LanguageEnglish
Pages457-467
Number of pages11
JournalHuman Reproduction
Volume27
Issue number2
DOIs
Publication statusPublished - 1 Jan 2012

Keywords

  • OHSS
  • assisted reproduction
  • body mass
  • ectopic pregnancy
  • multiple pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Koning, A. M. H., Mutsaerts, M. A. Q., Kuchenbecher, W. K. H., Broekmans, F. J., Land, J. A., Mol, B. W., & Hoek, A. (2012). Complications and outcome of assisted reproduction technologies in overweight and obese women. Human Reproduction, 27(2), 457-467. https://doi.org/10.1093/humrep/der416
Koning, A. M H ; Mutsaerts, M. A Q ; Kuchenbecher, W. K H ; Broekmans, F. J. ; Land, J. A. ; Mol, B. W. ; Hoek, A. / Complications and outcome of assisted reproduction technologies in overweight and obese women. In: Human Reproduction. 2012 ; Vol. 27, No. 2. pp. 457-467.
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Koning, AMH, Mutsaerts, MAQ, Kuchenbecher, WKH, Broekmans, FJ, Land, JA, Mol, BW & Hoek, A 2012, 'Complications and outcome of assisted reproduction technologies in overweight and obese women', Human Reproduction, vol. 27, no. 2, pp. 457-467. https://doi.org/10.1093/humrep/der416

Complications and outcome of assisted reproduction technologies in overweight and obese women. / Koning, A. M H; Mutsaerts, M. A Q; Kuchenbecher, W. K H; Broekmans, F. J.; Land, J. A.; Mol, B. W.; Hoek, A.

In: Human Reproduction, Vol. 27, No. 2, 01.01.2012, p. 457-467.

Research output: Contribution to journalArticle

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AU - Kuchenbecher, W. K H

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AB - BACKGROUND: Based on a presumed negative impact of overweight and obesity on reproductive capacity and pregnancy outcome, some national guidelines and clinicians have argued that there should be an upper limit for a woman's BMI to access assisted reproductive technologies (ART). However, evidence on the risk of complications or expected success rate of ART in obese women is scarce. We therefore performed a systematic review on the subject. METHODS: We searched the literature for studies reporting on complications or success rates in overweight and obese women undergoing ART. Articles were scored on methodological quality. We calculated pooled odds ratios (ORs) to express the association between overweight and obesity on the one hand, and complications and success rates of ART on the other hand. We only pooled results if data were available per woman instead of per cycle or embryo transfer. RESULTS: We detected 14 studies that reported on the association between overweight and complications during or after ART, of which 6 reported on ovarian hyperstimulation syndrome (OHSS), 7 on multiple pregnancies and 6 on ectopic pregnancies. None of the individual studies found a positive association between overweight and ART complications. The pooled ORs for overweight versus normal weight for OHSS, multiple pregnancy and ectopic pregnancy were 1.0 [95% confidence interval (CI) 0.77-1.3], 0.97 (95% CI 0.91-1.04) and 0.96 (95% CI 0.54-1.7), respectively. In 27 studies that reported on BMI and the success of ART, the pooled ORs for overweight versus normal weight on live birth, ongoing and clinical pregnancy following ART were OR 0.90 (95% CI 0.82-1.0), 1.01 (95% CI 0.75-1.4) and OR 0.94 (95% CI 0.69-1.3), respectively. CONCLUSIONS: Data on complications following ART are scarce and therefore a registration system should be implemented in order to gain more insight into this subject. In the available literature, there is no evidence of overweight or obesity increasing the risk of complications following ART. Furthermore, they only marginally reduce the success rates. Based on the currently available data, overweight and obesity in itself should not be a reason to withhold ART.

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Koning AMH, Mutsaerts MAQ, Kuchenbecher WKH, Broekmans FJ, Land JA, Mol BW et al. Complications and outcome of assisted reproduction technologies in overweight and obese women. Human Reproduction. 2012 Jan 1;27(2):457-467. https://doi.org/10.1093/humrep/der416