Cited by 111Assisted Reproductive Technology and Twin PregnancyPrenatal Screening and DiagnosticsReproductive Health and Technologies

Female obesity increases the risk of miscarriage of euploid embryos

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Cozzolino, Mauro, García-Velasco, Juan Antonio, Meseguer, Marcos, Pellicer, Antonio, Bellver, Jose·2021·Fertility and Sterility

Abstract

Objective To determine whether female body mass index (BMI) is associated with an increased risk of miscarriage after euploid embryo transfer. Design A retrospective, observational, multicenter cohort study. Setting University-affiliated in vitro fertilization center. Patient(s) In this study, 3,480 cycles of in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A) in the blastocyst stage and euploid embryo transfer were divided into four groups according to patient BMI. Intervention(s) In vitro fertilization with PGT-A. Main outcome measure(s) The primary outcome was the miscarriage rate, which included both biochemical and clinical miscarriages. Secondary outcomes were implantation, pregnancy, clinical pregnancy, and live birth rates. Result(s) Cycles were divided into four groups according to BMI (kg/m 2): underweight (<18.5; n = 155), normal weight (18.5-24.9; n = 2,549), overweight (25-29.9; n = 591), and obese (≥30; n = 185). The number of PGT-A cycles per patient was similar in the four groups. Fertilization rate, day of embryo biopsy, technique of chromosomal analysis, number of euploid embryos, number of transferred embryos, and method of endometrial preparation for embryo transfer were similar in the four BMI groups. Miscarriage rates were significantly higher in women with obesity compared to women with normal weight, mainly due to a significant increase in the clinical miscarriage rates. Live birth rates also were lower in women with obesity. Obesity in women and day 6 trophectoderm biopsy were found to influence the reduced live birth rate. Conclusion(s) Women with obesity experience a higher rate of miscarriage after euploid embryo transfer than women with a normal weight, suggesting that other mechanisms than aneuploidy are responsible for this outcome.

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Crossref · 10.1016/j.fertnstert.2020.09.139

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Authors
Cozzolino, M., García-Velasco, J. A., Meseguer, M., Pellicer, A., & Bellver, J.
Affiliations
  • Universidad Rey Juan Carlos (ES)
  • IVIRMA Global (ES)
Corresponding author
Cozzolino, Mauro
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2021-06
Volume
115
Issue
6
Pages
1495-1502
ISSN
0015-0282 (ISSN-L)
OpenAlex
W3108144574
Cited by
111
References
32
Citations by year
2026: 8 · 2025: 20 · 2024: 36 · 2023: 21 · 2022: 18 · 2021: 8
FWCI
11.29
Type
journal article
Language
en
Open access
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion)
Funders
  • Merck
  • Gedeon Richter
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords
female obesity, body mass index, miscarriage, euploid embryo transfer, preimplantation genetic testing for aneuploidy, blastocyst, live birth rate, clinical pregnancy, implantation rate
MeSH terms
Abortion, Spontaneous, Gestational Weight Gain, Pregnancy in Obesity, Obesity, Maternal, Aneuploidy, Blastocyst, Embryo Transfer, Female, Fertilization in Vitro, Genetic Testing, Humans, Infertility, Embryo Implantation, Pregnancy, Retrospective Studies, Risk Factors, Spain, Body Mass Index, Treatment Outcome, Risk Assessment, Pregnancy Rate, Preimplantation Diagnosis, Live Birth

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