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BMI has been proven to be a determinant factor in certain studies, reducing implantation rates and patient response to stimulation. The problem we encounter is that sometimes, due to the age of these patients, we do not have sufficient time to reduce their BMI. Particularly in patients over 40 or 41 years old, waiting 6 to 9 months to achieve the ideal BMI is not feasible, as it may impact the quality of the eggs. Therefore, whenever possible, especially in younger patients, we should aim for BMIs below 35 at least. In some cases where time is crucial, we may have to proceed with the procedure despite suboptimal BMI.
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Elevated BMI or obesity could interfere with the IVF outcome very much. Obese patients, in general, can have more health issues and of course, all these health issues can interfere with IVF, and with the IVF outcome. Obese patients with higher BMI – obesity, can cause problems in reaction to stimulation drugs. It could be the performance of oocytes pickup, egg retrieval could be problematic, and of course, obesity can interfere with the heart, lungs, and other health issues. And also we have to speak about extremely low BMI, which may as well have an important impact on the IVF outcome. We are talking about patients who have very low weight or anorexic patients who have also problems with their cycle – with their regularity cycle very often on ovulation and, of course, this can also be part of the problems in the IVF outcome.
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Being underweight or overweight could have a detrimental effect on the likelihood of achieving a pregnancy. Ideally, our BMI should be between 20 and 25, which is considered normal weight. We have seen that underweight or overweight patients might have a higher risk of miscarriages. It might be more difficult for them to achieve a pregnancy with or without IVF. Patients who undergo IVF, especially patients who are overweight or obese, have a higher risk of miscarriages and need a bigger dose of medication for achieving the same results or the same number of oocytes. The response to the medication might be more erratic, and the likelihood of achieving the pregnancy is lower.
Apart from that, not only from the perspective of the treatment itself, the risks during pregnancy. So-called obstetrics risks are higher for complications like preeclampsia, gestational diabetes, preterm delivery in all patients who do not have the ideal weight.
I would like to encourage all the people who are going to undergo fertility treatment or considering getting pregnant to try to keep their BMI as healthy as possible. Try to maximize the results and have a healthy pregnancy and successful outcome.
Answer from:
BMI, Body Mass Index, the healthy range should be between 19 and 25. Being under 19, underweight, can block spontaneous ovulation and pregnancy. Under IVF treatment, underweight can give a higher risk of hyper-stimulation and reduce the chance of implantation.
Being overweight or obese, when BMI is over 30 or higher, will also reduce the chances for ovulation and spontaneous pregnancy. In IVF treatments, a high BMI can reduce ovarian response to stimulation, it can also give us higher estrogenic levels, affecting endometrial thickness and quality for implantation. Other risks are thrombosis and thromboembolism, which might require preventive use of heparin during IVF treatment and also during pregnancy. Obese patients have a higher risk of diabetes, hypertension, preterm birth, and low weight newborns that might present cardiovascular problems long-life after birth.
