DOI QR코드

DOI QR Code

Body composition: A predictive factor of cycle fecundity

  • Kayatas, Semra (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital) ;
  • Boza, Aysen (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital) ;
  • Api, Murat (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital) ;
  • Kurt, Didar (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital) ;
  • Eroglu, Mustafa (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital) ;
  • Arinkan, Sevcan Arzu (Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Training and Research Hospital)
  • Received : 2014.03.19
  • Accepted : 2014.05.26
  • Published : 2014.06.30

Abstract

Objective: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. Methods: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. Results: Body fat mass was significantly lower in pregnant women than in non-pregnant women ($15.61{\pm}3.65$ vs. $18.78{\pm}5.97$, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient${\geq}0.277$, t-value ${\geq}2.537$; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. Conclusion: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.

Keywords

References

  1. Wise LA, Rothman KJ, Mikkelsen EM, Sorensen HT, Riis A, Hatch EE. An internet-based prospective study of body size and time-to-pregnancy. Hum Reprod 2010;25:253-64. https://doi.org/10.1093/humrep/dep360
  2. Catalano PM. Management of obesity in pregnancy. Obstet Gynecol 2007;109:419-33. https://doi.org/10.1097/01.AOG.0000253311.44696.85
  3. Murakawa H, Hasegawa I, Kurabayashi T, Tanaka K. Polycystic ovary syndrome. Insulin resistance and ovulatory responses to clomiphene citrate. J Reprod Med 1999;44:23-7.
  4. Mitwally MF, Kuscu NK, Yalcinkaya TM. High ovulatory rates with use of troglitazone in clomiphene-resistant women with polycystic ovary syndrome. Hum Reprod 1999;14:2700-3. https://doi.org/10.1093/humrep/14.11.2700
  5. Styne-Gross A, Elkind-Hirsch K, Scott RT Jr. Obesity does not impact implantation rates or pregnancy outcome in women attempting conception through oocyte donation. Fertil Steril 2005;83:1629-34. https://doi.org/10.1016/j.fertnstert.2005.01.099
  6. Wang JX, Warnes GW, Davies MJ, Norman RJ. Overweight infertile patients have a higher fecundity than normal-weight women undergoing controlled ovarian hyperstimulation with intrauterine insemination. Fertil Steril 2004;81:1710-2. https://doi.org/10.1016/j.fertnstert.2003.10.037
  7. Kirchengast S, Huber J. Body composition characteristics and fat distribution patterns in young infertile women. Fertil Steril 2004;81:539-44. https://doi.org/10.1016/j.fertnstert.2003.08.018
  8. Cosar E, Ucok K, Akgun L, Koken G, Sahin FK, Arioz DT, et al. Body fat composition and distribution in women with polycystic ovary syndrome. Gynecol Endocrinol 2008;24:428-32. https://doi.org/10.1080/09513590802234253
  9. World Health Organization Department of Reproductive Health and Research. Organization laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2010.
  10. Sung RY, Lau P, Yu CW, Lam PK, Nelson EA. Measurement of body fat using leg to leg bioimpedance. Arch Dis Child 2001;85:263-7. https://doi.org/10.1136/adc.85.3.263
  11. National Heart L, and Blood Institute; North American Association for the Study of Obesity. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD: National Heart, Lung, and Blood Institute; 2000. NIH Publication 1998, No. 98-4083.
  12. Dodson WC, Kunselman AR, Legro RS. Association of obesity with treatment outcomes in ovulatory infertile women undergoing superovulation and intrauterine insemination. Fertil Steril 2006;86:642-6. https://doi.org/10.1016/j.fertnstert.2006.01.040
  13. McClure N, McQuinn B, McDonald J, Kovacs GT, Healy DL, Burger HG. Body weight, body mass index, and age: predictors of menotropin dose and cycle outcome in polycystic ovarian syndrome? Fertil Steril 1992;58:622-4. https://doi.org/10.1016/S0015-0282(16)55276-5
  14. Spandorfer SD, Kump L, Goldschlag D, Brodkin T, Davis OK, Rosenwaks Z. Obesity and in vitro fertilization: negative influences on outcome. J Reprod Med 2004;49:973-7.
  15. Wass P, Waldenstrom U, Rossner S, Hellberg D. An android body fat distribution in females impairs the pregnancy rate of in-vitro fertilization-embryo transfer. Hum Reprod 1997;12:2057-60. https://doi.org/10.1093/humrep/12.9.2057
  16. Lashen H, Ledger W, Bernal AL, Barlow D. Extremes of body mass do not adversely affect the outcome of superovulation and invitro fertilization. Hum Reprod 1999;14:712-5. https://doi.org/10.1093/humrep/14.3.712
  17. Fedorcsak P, Dale PO, Storeng R, Ertzeid G, Bjercke S, Oldereid N, et al. Impact of overweight and underweight on assisted reproduction treatment. Hum Reprod 2004;19:2523-8. https://doi.org/10.1093/humrep/deh485
  18. Wattanakumtornkul S, Damario MA, Stevens Hall SA, Thornhill AR, Tummon IS. Body mass index and uterine receptivity in the oocyte donation model. Fertil Steril 2003;80:336-40. https://doi.org/10.1016/S0015-0282(03)00595-8
  19. Rouzi AA, Mackinnon M, McComb PF. Predictors of success of reversal of sterilization. Fertil Steril 1995;64:29-36.
  20. White DM, Polson DW, Kiddy D, Sagle P, Watson H, Gilling-Smith C, et al. Induction of ovulation with low-dose gonadotropins in polycystic ovary syndrome: an analysis of 109 pregnancies in 225 women. J Clin Endocrinol Metab 1996;81:3821-4.
  21. Nichols JE, Crane MM, Higdon HL, Miller PB, Boone WR. Extremes of body mass index reduce in vitro fertilization pregnancy rates. Fertil Steril 2003;79:645-7. https://doi.org/10.1016/S0015-0282(02)04807-0
  22. Wang JX, Davies M, Norman RJ. Body mass and probability of pregnancy during assisted reproduction treatment: retrospective study. BMJ 2000;321:1320-1. https://doi.org/10.1136/bmj.321.7272.1320
  23. Loveland JB, McClamrock HD, Malinow AM, Sharara FI. Increased body mass index has a deleterious effect on in vitro fertilization outcome. J Assist Reprod Genet 2001;18:382-6. https://doi.org/10.1023/A:1016622506479
  24. Ferlitsch K, Sator MO, Gruber DM, Rucklinger E, Gruber CJ, Huber JC. Body mass index, follicle-stimulating hormone and their predictive value in in vitro fertilization. J Assist Reprod Genet 2004;21:431-6. https://doi.org/10.1007/s10815-004-8759-1
  25. Zaadstra BM, Seidell JC, Van Noord PA, te Velde ER, Habbema JD, Vrieswijk B, et al. Fat and female fecundity: prospective study of effect of body fat distribution on conception rates. BMJ 1993;306:484-7. https://doi.org/10.1136/bmj.306.6876.484
  26. Douchi T, Oki T, Yamasaki H, Nakae M, Imabayashi A, Nagata Y. Body fat patterning in polycystic ovary syndrome women as a predictor of the response to clomiphene. Acta Obstet Gynecol Scand 2004;83:838-41. https://doi.org/10.1111/j.0001-6349.2004.00369.x
  27. Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM. Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr 2000;83:115-22. https://doi.org/10.1017/S0007114500000155
  28. Vehrs P, Morrow JR Jr, Butte N. Reliability and concurrent validity of Futrex and bioelectrical impedance. Int J Sports Med 1998;19:560-6. https://doi.org/10.1055/s-2007-971960

Cited by

  1. Risks Factors and Treatment Use Related to Infertility and Impaired Fecundity Among Reproductive-Aged Women vol.26, pp.5, 2014, https://doi.org/10.1089/jwh.2016.6052
  2. Body fat distribution influences ART outcomes vol.36, pp.1, 2014, https://doi.org/10.1080/09513590.2019.1630609