Legge, Alex - Effect of Obersity on IVF Pregnancy

73 Pages·2013·1.72 MB·English

The impact of obesity on in vitro
fertilization outcomes in women
Alex Legge
Dalhousie Medicine, Class of 2014
Supervisors: Dr. R. Bouzayen, Dr. D. Young, Dr. L. Hamilton
DMRF/Faculty of Medicine Summer Studentship (June – August 2011)
Objectives
• Describe the epidemiology of obesity
• Describe the effects of obesity on the
male & female reproductive systems
• Review the available literature on
obesity & in vitro fertilization
• Describe our study & it’s findings
Body Mass Index (BMI)
BMI (kg/m2) Weight Risk of Health
Classification Complications
<18.5 Underweight Increased
18.5-24.99 Normal Weight Least
25-29.99 Overweight Increased
30+ Obese
30-34.99 Class 1 Obesity High
35-39.99 Class 2 Obesity Very High
40+ Class 3 Obesity Extremely High
A growing problem…
Adolescent Obesity
Between 1978/79 and 2004:

The percentage of Canadian adolescents (age 12-
17)with a BMI > 25 kg/m2 increased from 14% to 29%

Obesity rates for Canadian adolescents (age 12-17)
increased from 3% to 9%
Medical Complications of Obesity
Source: Batch & Baur. MJA 2005; 182 (3): 130-135.
Obesity & Reproduction
MEN
Abnormal hormone profiles
Impaired sperm parameters
Infertility
WOMEN
Menstrual irregularities/Anovulation
Polycystic ovary syndrome (PCOS)
Infertility
Obesity & Male Reproduction
Abnormal hormone profiles
Male obesity is associated with:

Decreased serum total testosterone levels
Aggerholm et al. 2007, Jensen et al. 2004, Wu et al. 2008, etc.

Decreased Testosterone/Estradiol ratio
Jarow et al. 1993, Fejes et al. 2006

Decreased serum SHBG levels
Aggerholm et al. 2007, Jensen et al. 2004, Wu et al. 2008, etc.
Obesity & Male Reproduction
Sperm Parameters
Belloc et al. 2011 Fertility & Sterility

5874 male patients at a private ART clinic in France

Compared semen parameters for normal weight and obese
patients, controlling for age

Semen volume, sperm concentration, total sperm count, and
sperm motility were all significantly decreased in the obese group
(P<0.001)
Obesity & Male Reproduction
Sperm Parameters
Duits et al. 2010 Fertility & Sterility

1466 men visiting fertility clinic as part of subfertile couple

Compared semen parameters between underweight, normal
weight, overweight, and obese men

Controlled for age, smoking, alcohol use, DM

No statistically significant differences in semen quality between
BMI groups