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Updated: Apr 8, 2026

Human Blastocyst Biopsy and Vitrification
Published on: July 26, 2019
Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro
Ioanna A Comstock1, Sun Kim2, Barry Behr3
1Obstetrics and Gynecology-Reproductive Endocrinology and Infertility, Stanford Hospital and Clinics, 900 Welch Rd Ste 350 MC 5800, Palo Alto, CA, 94304, USA. icomstoc@stanford.edu.
Purpose:
The aim of this study is to investigate the effect of female BMI and metabolic dysfunction on blastocyst formation rate.
Methods:
This was a retrospective cohort study that was performed in an academic center for reproductive medicine. Patients who were normal weight, overweight with metabolic dysfunction, or obese who had ≥6 oocytes retrieved in a fresh IVF cycle were included in the study. The blastocyst formation rate was calculated from the number of ≥5 cell embryos on day 3 observed in culture until day 5 or day 6. Only good quality blastocysts were included in the calculation as defined by a morphologic grade of 3BB or better.
Results:
The blastocyst formation rate was significantly better in the normal-weight controls versus overweight/obese patients (57.2 versus 43.6 %, p < 0.007). There was no difference in blastocyst formation between the patients with a BMI 25-29.9 kg/m(2) with metabolic dysfunction and those with a BMI ≥30 kg/m(2).
Conclusion:
The maternal metabolic environment has a significant impact on embryo quality as measured by blastocyst formation. A decreased blastocyst formation rate is likely a significant contributor to poorer reproductive outcomes in overweight and obese women with infertility.
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