| According to WHO.about 13%of the world’s adult population(1 1%of men and 15%of women)were obese in 2016.Raised BMI is a major risk factor for noncommunicable diseases such as cardiovascular diseases,diabetes and some cancers.Obesity can also influence female fertility and can enlarge their time-to-pregnancy.especially among couples seeking infertility treatment.Raised BMI in women can reduce live birth rate and increase the incidence of gestational diabetes(GDM),gestational hypertension and pre-eclampsia.Obesity can lead to hypogonadotropic hyperestrogenic hypoandrogenism.impaired spermatogenesis or epigenetic alterations in men.These can impair the male fertility and may influence the offerings.Altuough many studies have evaluated the negative effect of male or female obesity on pregnancy outcomes,studies about combined impact of couples’BMI are scarce.Couples undergoing ART treatment are likely to share lifestyle choices.Thus,cases of combined parental obesity or combined parental normal weight are becoming more and more common.A few study have evaluated the combined influence of couple’s BMI on pregnancy outcomes following a fresh cycle or a frozen-throw cycle.However,no study to date has investigated the combined impact of female and male body mass index on the cumulative pregnancy outcomes and dropout rate after the first ovarian stimulation.It is necessary to elucidate the effect of couple’s BMI on the cumulative pregnancy outcomes and dropout rate after the first ovarian stimulation.ObjectiveTo evaluate the effect of couple’s BMI on the pregnancy outcomes after fresh cycle,the cumulative pregnancy outcomes after the first ovarian stimulation for in vitro fertilization.Then,to investigate the predictors for discontinuation during the first ovarian stimulation.Materials and MethodPatients were retrospectively collected from the Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University between June 2009 and June 2016 who have available embryos after their first ovarian stimulation.Patient were divided into four groups:Group A(both male and female BMI<25 kg/m2),group B(female BMI≥25 kg/m2 and male BMI<25 kg/m2),group C(female BMI<25 kg/m2 and male BMI≥25 kg/m2)and group D(both male and female BMI>25 kg/m2).Results1.Regardless of whether relevant confounders were adjusted for,couples with a female BMI≥25 kg/m2(regardless of male BMI)had a lower CPR and LBR than couples with both male and female BMI<25 kg/m2 in the fresh cycle(P<0.05).Among couples with a female BMI<25 kg/m2,those with a male BMI≥25 kg/m2 and<25 kg/m2 were comparable in terms of CPR,LBR(P>0.05).2.Regardless of whether relevant confounders were adjusted for,couples with a female BMI≥25 kg/m2(any male BMI)had a significantly lower CCPR and CLBR than couples with both male and female BMI<25 kg/m2(P<0.05)after the first ovarian stimulation.Among couples with a female BMI<25kg/m2,those with a male BMI≥25 kg/m2.and<25 kg/m2 were comparable in terms of CCPR,CLBR(P>0.05).3.After adjusting for confounders,our study showed female age(aOR1.06,95%CI 1.04-1.07),female BMI(Group B:aOR1.34,95%CI 1.13-1.58;Group D:aOR1.33,95%CI 1.14-1.55)and the number of oocytes retrieved(aOR1.02,95%CI 1.02-1.03)positively impacted the dropout rate4.The main contributor to the high cumulative pregnancy rate was the fresh cycle rather than the frozen embryo cycle.Conclusions1.Among couples with a female BMI≥25kg/m2,raised female BMI negatively affects CPR.LBR.CCPR.CLBR and positively affects dropout rate.2.Among couples with a female BMI<25 kg/m2,male BMI did not influence pregnancy outcomes.3.Female age and BMI positively impacts the dropout rate.Moreover.Our data showed a neutral effect of male age and BMI on dropout rate. |
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