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BMI and miscarriage after IVF.

José Bellver^1,2,3

¹IVIRMA.

Current Opinion in Obstetrics & Gynecology

|June 1, 2022

Summary

This summary is machine-generated.

Obese women undergoing IVF have a higher risk of miscarriage, even with euploid embryos. This increased pregnancy loss is likely due to uterine environment changes caused by obesity, not embryo quality.

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Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage

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Published on: August 4, 2021

Area of Science:

Reproductive Endocrinology
Maternal-Fetal Medicine
In Vitro Fertilization (IVF)

Background:

Obesity is a growing concern in reproductive health.
Increased miscarriage rates are observed in both natural conception and assisted reproductive technologies for overweight and obese women.
Understanding the mechanisms behind these increased risks is crucial for improving IVF outcomes.

Purpose of the Study:

To review recent findings on the risk of miscarriage in women with elevated Body Mass Index (BMI) undergoing In Vitro Fertilization (IVF).
To explore the underlying mechanisms contributing to the elevated miscarriage risk in this population.

Main Methods:

Review of recent scientific literature and studies.
Analysis of data concerning oocyte and embryo quality (morphological and morphokinetic parameters).
Investigation of metabolomic, epigenetic, and uterine environmental factors in relation to BMI and miscarriage.

Main Results:

Oocyte and embryo quality, by standard morphological assessment, is not significantly affected by elevated BMI.
Blastocyst formation and quality are similar across BMI groups, even for euploid embryos.
Despite normal embryo parameters, miscarriage rates are higher in obese women, suggesting uterine or other non-embryo-related factors.

Conclusions:

The increased miscarriage risk in obese women undergoing IVF appears linked to the uterine environment, potentially influenced by endocrine, metabolic, and inflammatory changes associated with obesity.
Metabolomic, epigenetic, or mitochondrial dysfunction in oocytes/embryos, as well as implantation window displacement, are potential contributing factors.
Weight reduction prior to conception is recommended for obese women seeking pregnancy.