Purpose

As obesity becomes increasingly prevalent, its impact on fertility has been a subject of great debate. Nearly all prior research is retrospective and evaluates obesity utilizing body mass index (BMI), which may overestimate adiposity in individuals with a greater amount of lean muscle and underestimate adiposity in those with less muscle mass.

Methods

We prospectively evaluated 2013 couples undergoing infertility treatment with in vitro fertilization (IVF). Percent body fat (%BF) was measured by use of a bioelectric impedance analysis (BIA) scale at baseline. BMI was also determined. Ovarian reserve parameters, ovarian response to controlled ovarian hyperstimulation, and semen analyses were measured in correlation with their %BF and BMI.

Results

Females classified as obese based on %BF or BMI had lower serum FSH. However, when the analysis was limited to women without PCOS (n = 1706), obesity based on %BF or BMI was associated with lower serum AMH. Female obesity—regardless of a PCOS diagnosis—did not affect number of mature oocytes retrieved. Males who were in obese %BF category were found to have lower TMSC compared with normal weight counterparts (p < 0.05); however, the observed decrease was not significant enough to limit the success of assisted reproductive technologies.

Conclusions

These findings suggest that while obesity may affect ovarian reserve in women variably depending on presence of PCOS, it does not affect number of mature oocytes available after COH. Similarly, while a high %BF in males is associated with lower TMSC, the observed difference is unlikely to affect IVF outcomes.

中文翻译：

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身体含量评估（ABC）试验：肥胖不会显着影响不育男性和女性的配子生成。

 目的

随着肥胖变得越来越普遍，其对生育力的影响一直是一个备受争议的话题。几乎所有先前的研究都是回顾性的，并利用体重指数（BMI）来评估肥胖情况，这可能会高估瘦肌肉较多的个体的肥胖情况，而低估肌肉质量较少的个体的肥胖情况。

 方法

我们前瞻性地评估了 2013 对接受体外受精 (IVF) 不孕症治疗的夫妇。通过使用生物电阻抗分析 (BIA) 量表在基线测量体脂百分比 (%BF)。还测定了体重指数。卵巢储备参数、卵巢对受控卵巢过度刺激的反应以及精液分析的测量与其 %BF 和 BMI 相关。

 结果

根据 %BF 或 BMI 分类为肥胖的女性血清 FSH 较低。然而，当分析仅限于没有 PCOS 的女性 ( n = 1706) 时，基于 %BF 或 BMI 的肥胖与较低的血清 AMH 相关。女性肥胖——无论多囊卵巢综合症的诊断如何——并不影响取出的成熟卵母细胞的数量。与正常体重的男性相比，肥胖 %BF 类别的男性 TMSC 较低 ( p < 0.05)；然而，观察到的下降幅度不足以限制辅助生殖技术的成功。

 结论

这些发现表明，虽然肥胖可能会根据 PCOS 的存在而不同程度地影响女性的卵巢储备功能，但它不会影响 COH 后可用的成熟卵母细胞的数量。同样，虽然男性的高 %BF 与较低的 TMSC 相关，但观察到的差异不太可能影响 IVF 结果。