Objective of the study. To estimate the processes of oogenesis and early embryogenesis as well as the rate of gestation and reproductive losses in the first trimester of pregnancy in women of older reproductive age with infertility undergoing treatment in vitro fertilization (IVF) programs depending on their body mass index.
MATERIAL AND METHODS
A total of 400 infertile patients undergoing IVF treatment were examined. Group 1 included 257 patients aged 35—39 years, Group 2 included 143 patients aged 40—45 years. There were 5 subgroups in each group depending on the body mass index. All the patients underwent the standard IVF treatment for tubal-peritoneal infertility or the combination of tubal-peritoneal factor and chronic anovulation. To assess the effect of age and BMI on the efficacy of the IVF program the following parameters were examined: the average dose of drugs used to induce superovulation, the rate of pregnancy onset, the rate of «biochemical» and failed pregnancies in the first trimester, the number of patients in whom all oocytes were of low quality and failed to fertilize, and the number of patients in whom neither embryo transfer nor cryopreservation were performed because of poor embryo quality.
RESULTS
Impaired oogenesis and embryogenesis (increased number of low-quality oocytes and embryos, higher number of unfertilized oocytes, as well as more cases of failed embryo transfer or cryopreservation in patients aged 35—39 with degree II obesity and negative outcomes of IVF programs in patients aged 40—45 were also observed in overweight and degree I-II obesity. The data obtained suggest a certain concomitant adverse effect of the age factor and obesity in older women of reproductive age with infertility on the efficiency of IVF treatment.
CONCLUSION
Obesity in older age group should be regarded as an additional factor that adversely affects the reproductive outcome of IVF programs. Patients with obesity in the over-40 age group should be recommended to achieve pregnancy by using donor oocytes.
