A recent study from Spain published in Fertility and Sterility (Fertil Steril 2013;100:1050-8) involving 9,587 first cycles using donor eggs from normal weight women found significantly lower success rates in obese recipients. In vitro fertilization laboratory parameters did not differ according to BMI defined as lean (BMI<20), of normal weight (BMI 20-24.9), over weight (BMI 25-29.9), and obese (BMI >30). However, implantation, pregnancy, clinical pregnancy, twin pregnancy and live-birth rates were significantly reduced as BMI increased. Their conclusion was that female obesity in donor recipients lowers success rates most likely due to reduced uterine receptivity. Precisely how this happens is still speculative but as a general disease, obesity probably affects all aspects of reproduction including sperm quality, egg quality, embryo quality and uterine receptivity. Therefore weight management should be an integral part of therapy before natural or assisted reproduction whether using autologous or donated eggs.
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