| Abstract [eng] |
Introduction. Growing evidence highlights the negative impact of obesity on assisted reproductive technology outcomes, as obesity has been associated with reduced fertilization efficiency and implantation potential, as well as lower clinical pregnancy and live birth rates. However, some studies report no significant association between obesity and assisted reproduction outcomes. Aim. To evaluate the impact of female obesity on the effectiveness and clinical outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Objectives. To assess the association between obesity and ovarian stimulation parameters, embryo development, as well as human chorionic gonadotropin (hCG)-confirmed pregnancy and ongoing pregnancy up to 10 weeks of gestation. Methods. This retrospective study included patients who underwent IVF or ICSI procedures at the Fertility Center of Vilnius University Hospital Santaros Klinikos between January 1, 2023, and October 30, 2024. Patients who underwent ovarian stimulation prior to oncological treatment and couples using donor gametes were excluded. According to BMI, patients were categorized into five groups: <18,5; 18,5–24,9; 25–29,9 , 30–34,9, and ≥ 35. Binary logistic regression was used for categorical variables, while Kruskal–Wallis and Spearman correlation tests were applied for continuous variables. Statistical analysis was performed using IBM® SPSS Statistics 31.1. Results. Higher gonadotropin doses were required in overweight and obese groups; differences were statistically significant between the normal-weight and overweight (p < 0.001), class I obesity (p < 0.001), and class II–III obesity (p = 0.035) groups. The numbers of retrieved and mature oocytes did not differ significantly between BMI groups (p > 0.05). Increasing BMI, as a continuous variable, was associated with a lower number of fertilized oocytes (ρ = −0.094; p = 0.025). Class II–III obesity was associated with fewer developed blastocysts compared with the normal-weight group (p = 0.006). No statistically significant differences were observed in hCG-confirmed pregnancy rates among groups (p > 0.05); however, class I obesity was associated with significantly lower odds of ongoing pregnancy up to 10 weeks of gestation compared with the normal-weight group (OR = 0.338, 95% CI: 0.120–0.955, p = 0.041). Conclusion. Obesity is associated with increased gonadotropin requirements but does not significantly affect stimulation duration or the number of retrieved or mature oocytes. Obesity may negatively impact early embryo development, particularly at the blastocyst stage. Furthermore, obesity was associated with poorer clinical outcomes, as reflected by a significantly lower rate of ongoing pregnancy. |
