Research by board-certified reproductive endocrinologist Richard Sherbahn, MD, at the Advanced Fertility Center of Chicago reveals that women with a higher body mass index have more eggs retrieved -- but not a correspondingly higher rate of success -- with in-vitro fertilization.
Gurnee, Ill. (PRWeb) May 14, 2009 -- Infertility specialist Richard Sherbahn, MD, and embryologist Ellen Gibbons recently presented research to the American Society for Reproductive Medicine regarding the influence of a woman's body mass index on her chances of success with infertility treatment.
Dr. Sherbahn and Gibbons conducted a retrospective study of 1,150 in-vitro fertilization (IVF) cycles in women under age 40, using their own eggs, from January 2003 through July 2007.
The cases were divided into two groups according to their body mass index (BMI). One group consisted of women with a BMI of 30 or above -- considered obese. Women in the other group had a BMI under 30. (Normal BMI is 18.5 - 24.9, according to the Centers for Disease Control and Prevention.)
IVF patients who had four or more good-quality embryos three days after fertilization had their embryos cultured in the lab for uterine transfer on day five. The researchers compared the two BMI groups' average antral follicle count (a predictor of the total number of eggs remaining in a woman's ovaries).
They also compared the number of eggs retrieved, rate of embryo implantation, clinical pregnancy rate, live birth success rate, as well as the rates of miscarriage, day-three and day-five IVF transfer and IVF cycle cancellation.
"Antral follicles are tiny cystic structures in the ovaries -- measuring only two to eight millimeters -- that contain eggs," Dr. Sherbahn explains. "A woman's eggs grow to maturity in these follicles. We can see antral follicles, also known as resting follicles, on an ultrasound."
"In my opinion, the antral follicle count is the best tool we have for estimating the number of eggs left in a woman's ovaries," says Dr. Sherbahn. "This count, in conjunction with a woman's age, is a good method for gauging her chances of success with in-vitro fertilization. Normally, the more antral follicles, the more eggs -- and the greater a woman's chances of IVF success."
"Our research found that the average number of antral follicles and eggs retrieved was significantly higher in the group of women with 30-plus BMI," Dr. Sherbahn explains.
The rate of day-five embryo transfers -- which have a greater chance of success than day-three transfers -- was also significantly higher in the increased BMI group. "We did not find any notable differences between the two BMI groups in the other variables we studied," says Dr. Sherbahn.
Although the women with a higher BMI had significantly more antral follicles and eggs retrieved and a higher likelihood of having a day-five transfer, there was no difference between the BMI groups in the rates of clinical pregnancy, miscarriage or live births.
"It's possible that the higher number of eggs and greater chance for a day-five transfer is due to a higher incidence of polycystic ovary syndrome in women with a BMI of 30 or greater," says Dr. Sherbahn. "Women with polycystic ovary syndrome will often have irregular menstrual cycles and not ovulate and will have difficulty getting pregnant."
"Overall in our IVF program, women who have day-five embryo transfers have significantly higher pregnancy and live birth rates than women who have day-three transfers," Dr. Sherbahn explains. "Because there was a higher rate of day-five transfers in the high-BMI group -- but not a corresponding increase in implantation, clinical pregnancy or live births -- we speculate that either embryo viability or uterine receptivity may be compromised in high-BMI women."
"Because the embryo transfer procedure itself can be more difficult in women with a BMI of 30 or greater, there could also be a loss of efficiency in the transfer," he concludes. "Especially when treating women with a high BMI or other anatomy-related issues, IVF success depends greatly on the skill of the physician performing the embryo transfer."
The Advanced Fertility Center of Chicago, with offices in Gurnee and Crystal Lake, Ill., offers advanced reproductive technology services such as in-vitro fertilization (IVF), intracytoplasmic sperm injection and egg donation.
The Center specializes in individualized care, and enjoys IVF success rates consistently higher than the national average. Its highly successful egg donation program has egg donors available immediately, with no third-party egg donor agency needed.
The Center's web site, www.advancedfertility.com, offers more than 200 articles on fertility issues and IVF. To schedule an appointment at the Gurnee office, call 847.662.1818. For an appointment at the Crystal Lake office, call 815.356.1818.
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