Effect of body mass index on the outcome of IVF cycles among patients with poor ovarian response

Objective To assess the effects of body mass index (BMI) on the outcome of IVF cycles among poor responders. Methods A prospective cohort study in Egypt enrolled 185 poor responders who underwent intracytoplasmic sperm injection via an antagonist protocol between 2012 and 2017. Participants were classified into three groups by BMI (calculated as weight in kilograms divided by the square of height in meters): 18.5–24.9 (normal, n=48); 25–29.9 (overweight, n=54); 30 or higher (obese, n=83). Outcomes were clinical pregnancy rate, implantation rate, chemical pregnancy rate, gonadotropin dose, number of oocytes and embryos, and cancellation rate. Results There was no significant difference among the three groups in gonadotropin dose; duration of stimulation; endometrial thickness on trigger day; number of oocytes retrieved, injected, or fertilized; number of embryos, transferred embryos, or frozen embryos; or day of embryo transfer. Frequency of implantation (11/81 [14%] vs 6/96 [6%] or 5/155 [3%]), chemical pregnancy (20 [42%] vs 14 [30%] or 12 [14%]) and clinical pregnancy (15 [31%] vs 12 [22%] and 9 [11%]) was significantly higher for normal than for overweight or obese women, respectively. Conclusion Implantation, chemical pregnancy, and clinical pregnancy rates were inversely related to increasing BMI. ClinicalTrials.gov: NCT03457233 Among poor responders, IVF outcomes including implantation, chemical pregnancy, and clinical pregnancy rates were significantly lower for overweight and obese women.