The effectiveness of programs of embryo cryo-transfer into the uterine cavity in women with overweight and obesity

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Abstract

Relevance: Overweight and obesity is a medical and social issue, which has a tendency to progress. It is known about the negative impact of obesity on the cardiovascular system, musculoskeletal system, and increased risk of developing diabetes. The incidence of gynecological diseases and the risk of developing obstetric complications is higher in patients with obesity. The patients with obesity have high prevalence of gynecological diseases and the risk of developing obstetric complications. There is data on reduced effectiveness of assisted reproductive technology (ART) programs in women of this category.

Objective: The purpose of the study was to make a comparative analysis of the effectiveness of the programs of thawed embryo transfer into the uterine cavity in women with overweight and obesity.

Materials and methods: The study included 186 patients. Among them, 76 women had overweight and obesity, and 110 women had normal weight. All patients underwent infertility treatment using the program of thawed embryo transfer into the uterine cavity. The comparison was made between clinical pregnancy rate (CPR) and the rate of early reproductive losses before 12 weeks’ gestation depending on the body mass index (BMI).

Results: In both groups the patients were comparable in menstrual function, the frequency of comorbidities and gynecological diseases, infertility duration and the number of previous ART attempts in history. The age of patients in the group with BMI≥25 kg/м2 was higher, but the difference in age had no statistically significant influence on pregnancy rate (PR) and miscarriage rate, as well as preimplantation genetic testing for aneuploidy (PGT-A), that was used to test some embryos, which were transferred to patients in both groups. It was found that in patients with BMI≥25 kg/м2 the chances of getting pregnant reduced by 2 times, and the chances of early reproductive losses before 12 weeks’ gestation increased by 3.6 times.

Conclusion: Overweight and obesity reduce the effectiveness of the programs of thawed embryo transfer into the uterine cavity, most likely due to reduction of embryo implantation potential, including euploid embryos.

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About the authors

Elizaveta E. Kraevaya

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: e_kraevaya@oparina4.ru
ORCID iD: 0000-0002-8140-0035

PhD, Researcher at the Department of Assisted Technologies for the Treatment of Infertility

Russian Federation, Moscow

Natalya P. Makarova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: np_makarova@oparina4.ru
ORCID iD: 0000-0003-1396-7272

Dr. Bio. Sci., Leading Researcher at the Department of Assisted Technologies for the Treatment of Infertility

Russian Federation, Moscow

Elena A. Kalinina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_kalinina@oparina4.ru
ORCID iD: 0000-0002-8922-2878

Dr. Med. Sci., Professor, Head of the Department of Assisted Technologies for the Treatment of Infertility

Russian Federation, Moscow

Tatyana A. Nazarenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_nazarenko@oparina4.ru
ORCID iD: 0000-0002-5823-1667

Dr. Med. Sci., Professor, Director of the Institute of Reproductive Medicine, Head of the F. Paulsen Scientific and Clinical Department of IVF

Russian Federation, Moscow

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