The impact of obesogenic disturbances on in vitro fertilization outcomes in a Mexican population.

Abstract

CONTEXT: Overweight and obese patients tend to have more difficulty getting pregnant through in vitro fertilization (IVF), but it is still unclear whether this effect varies by ethnicity and age. AIMS: To assess the effect obesity has on IVF among infertile, advanced-age (≥ 35 years) Mexican women. METHODS: Retrospectively, data were collected from the INGENES Institute (2018-2022; n = 2,232). Pearson's correlation coefficient (r) was calculated to evaluate associations. The area under the receiver operating characteristic curve (AUC) determined the predictability of body mass index (BMI) for IVF with the highest Youden index score (sensitivity + specificity - 1) as the optimal cutoff value. Logistic regression was used to calculate risk (odds ratios (ORs) with 95% confidence intervals (95%CIs)). KEY RESULTS: BMI was negatively correlated with IVF outcomes (P < 0.001): biochemical pregnancy (r = -0.164), clinical pregnancy (r = -0.188), and live birth (r = -0.202). BMI cutoffs to predict IVF success were: ≤ 25.1 kg/m2 for biochemical pregnancy (AUC = 0.63; specificity = 71.4%; sensitivity = 50.1%); ≤ 24.0 kg/m2 for clinical pregnancy (AUC = 0.65; specificity = 85.3%; sensitivity = 40.2%), and ≤ 24.0 kg/m2 for live birth (AUC = 0.67; specificity = 85.7%; sensitivity = 44.4%). Overweight or obese patients had higher risks of not having transferable embryos (OR = 2.7, 95%CI: 2.1-3.4 and OR = 3.8, 95%CI: 2.5-5.6, respectively, P < 0.001) and failed embryo implantation (OR = 3.1, 95%CI: 2.3-3.9 and OR = 4.7, 95%CI: 3.2-7.1, respectively, P < 0.001). The risk of pregnancy loss was also higher in patients who were overweight (OR = 4.7, 95%CI: 2.4-9.4, P < 0.001) and obese (OR = 4.0, 95%CI: 1.5-10.8, P = 0.006). CONCLUSION: BMI was highly associated with and predicted IVF failure. IMPLICATIONS: Obesity is a prevalent factor that affects each stage of IVF; diet and other weight management treatments need to be implemented to promote IVF success.