Obesity is associated with lower live birth rates in women having IVF and other ART related procedures compared to women who are not obese. A recent study published in the American Journal of Obstetrics and Gynecology of 264 women who underwent 445 ART cycles found that waist circumference was independently associated with successful pregnancies. Women with a BMI between 18.5 and 25 kg/m2 and a waist circumference less than 77 cm (30 inches) had the highest live birth rate (58%). While women with a BMI greater than 25 kg/m2 and a waist circumference greater than 30 inches had the lowest live birth rate (38%). Waist circumference, independent of BMI, was also found to be inversely related to the probability of live birth in women having ART procedures for infertility.
Life style modification remains the first line of therapy and includes calorie restriction and increased physical activity. Supervised medical therapy or bariatric surgery should also be considered. If bariatric surgery is performed, pregnancy should be postponed for a year so that metabolic stability can be affirmed. Unfortunately, many because of advancing age may not be able to afford the time to wait until ideal body weight is achieved.
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