Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS

IntroductionFemale obesity has been conclusively associated with compromised fertility, adverse pregnancy outcomes and higher risks of obstetric and neonatal complications. However, it remains unclear whether the adverse outcomes observed in IVF treatments among women with obesity are primarily due...

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Main Authors: Shuo Huang, Zheng Wang, Rui Yang, Rong Li, Jie Qiao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1552561/full
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author Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rong Li
Rong Li
Rong Li
Rong Li
Rong Li
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
author_facet Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rong Li
Rong Li
Rong Li
Rong Li
Rong Li
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
author_sort Shuo Huang
collection DOAJ
description IntroductionFemale obesity has been conclusively associated with compromised fertility, adverse pregnancy outcomes and higher risks of obstetric and neonatal complications. However, it remains unclear whether the adverse outcomes observed in IVF treatments among women with obesity are primarily due to obesity itself or to underlying pathologies such as PCOS. Studies investigating the impact of overweight/obesity compared to normal weight in women with PCOS have yielded inconsistent findings.MethodsWe retrospectively analyzed 4083 women with PCOS undergoing the first IVF-ET cycle with antagonist protocol. Among them, 1755 were divided into the normal weight group (18.5 g/m2 ≤ BMI < 24.0 kg/m2), 1398 into the overweight group (24.0 kg/m2 ≤ BMI < 28.0 kg/m2) and 930 into the obese group (BMI ≥ 28.0 kg/m2). The primary outcome was live birth. Other outcomes were cycle parameters, embryological, pregnancy outcomes and birth weight of newborns. We additionally investigated potential associations of maternal BMI as a continuous variable with outcomes for both linear associations and non-linear associations.ResultWomen with overweight and obese had fewer numbers of oocytes retrieved (adjusted B: -0.82 [-1.17 to -0.47] and adjusted B: -1.86 [-2.26 to -1.46], respectively), numbers of 2PN (adjusted B: -0.52 [-0.78 to -0.26] and adjusted B: -1.86 [-2.26 to -1.46]), and numbers of good-quality embryos (adjusted B: -0.34 [-0.57 to -0.12] and adjusted B: -0.88 [-1.13 to -0.62]), compared to the women with normal weight. The live birth rate was 35.7%, 30.6% and 27.2% in the normal weight group, the overweight group and obese group, respectively (adjusted OR:0.76 [0.65 to 0.89]) for overweight verse normal weight, and adjusted OR:0.64 [0.53 to 0.76)] for obese verse normal weight). There were significant associations between higher BMI and adverse outcomes. We did not observe significant non-linear associations between BMI and these outcomes.DiscussionOverweight or obese women with PCOS undergoing IVF-ET experienced lower numbers of oocytes and good quality embryos, reduced rates of live births, and higher rates of miscarriage compared to normal-weight women with PCOS.
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spelling doaj-art-db136b8236414fbf80d511edd3a8ad6a2025-08-20T01:49:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-03-011610.3389/fendo.2025.15525611552561Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOSShuo Huang0Shuo Huang1Shuo Huang2Shuo Huang3Shuo Huang4Zheng Wang5Zheng Wang6Zheng Wang7Zheng Wang8Zheng Wang9Rui Yang10Rui Yang11Rui Yang12Rui Yang13Rui Yang14Rong Li15Rong Li16Rong Li17Rong Li18Rong Li19Jie Qiao20Jie Qiao21Jie Qiao22Jie Qiao23Jie Qiao24State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaNational Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, ChinaBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaState Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaNational Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, ChinaBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaState Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaNational Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, ChinaBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaState Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaNational Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, ChinaBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaState Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaNational Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, ChinaBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, ChinaCenter for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, ChinaIntroductionFemale obesity has been conclusively associated with compromised fertility, adverse pregnancy outcomes and higher risks of obstetric and neonatal complications. However, it remains unclear whether the adverse outcomes observed in IVF treatments among women with obesity are primarily due to obesity itself or to underlying pathologies such as PCOS. Studies investigating the impact of overweight/obesity compared to normal weight in women with PCOS have yielded inconsistent findings.MethodsWe retrospectively analyzed 4083 women with PCOS undergoing the first IVF-ET cycle with antagonist protocol. Among them, 1755 were divided into the normal weight group (18.5 g/m2 ≤ BMI < 24.0 kg/m2), 1398 into the overweight group (24.0 kg/m2 ≤ BMI < 28.0 kg/m2) and 930 into the obese group (BMI ≥ 28.0 kg/m2). The primary outcome was live birth. Other outcomes were cycle parameters, embryological, pregnancy outcomes and birth weight of newborns. We additionally investigated potential associations of maternal BMI as a continuous variable with outcomes for both linear associations and non-linear associations.ResultWomen with overweight and obese had fewer numbers of oocytes retrieved (adjusted B: -0.82 [-1.17 to -0.47] and adjusted B: -1.86 [-2.26 to -1.46], respectively), numbers of 2PN (adjusted B: -0.52 [-0.78 to -0.26] and adjusted B: -1.86 [-2.26 to -1.46]), and numbers of good-quality embryos (adjusted B: -0.34 [-0.57 to -0.12] and adjusted B: -0.88 [-1.13 to -0.62]), compared to the women with normal weight. The live birth rate was 35.7%, 30.6% and 27.2% in the normal weight group, the overweight group and obese group, respectively (adjusted OR:0.76 [0.65 to 0.89]) for overweight verse normal weight, and adjusted OR:0.64 [0.53 to 0.76)] for obese verse normal weight). There were significant associations between higher BMI and adverse outcomes. We did not observe significant non-linear associations between BMI and these outcomes.DiscussionOverweight or obese women with PCOS undergoing IVF-ET experienced lower numbers of oocytes and good quality embryos, reduced rates of live births, and higher rates of miscarriage compared to normal-weight women with PCOS.https://www.frontiersin.org/articles/10.3389/fendo.2025.1552561/fullPCOSIVF-ETobesitylive birthinfertility
spellingShingle Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Shuo Huang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Zheng Wang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rui Yang
Rong Li
Rong Li
Rong Li
Rong Li
Rong Li
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
Jie Qiao
Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
Frontiers in Endocrinology
PCOS
IVF-ET
obesity
live birth
infertility
title Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
title_full Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
title_fullStr Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
title_full_unstemmed Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
title_short Embryological and pregnancy outcomes of IVF-ET in overweight/obese and normal-weight women with PCOS
title_sort embryological and pregnancy outcomes of ivf et in overweight obese and normal weight women with pcos
topic PCOS
IVF-ET
obesity
live birth
infertility
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1552561/full
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