ArticleJournal of assisted reproduction and genetics2026
Obesity and morbid obesity are associated with reductions in live birth rate and increased miscarriage rate after frozen embryo transfer.
Article in Journal of assisted reproduction and genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeObesity is associated with poor in-vitro fertilization (IVF) outcomes, with limited data on patients with BMI ≥ 40 kg/m
methodsA retrospective cohort study (2017-2024) of 1,424 FETs from 889 patients, stratified by BMI: normal (18.5-24.9), overweight (25.0-29.9), obese (30.0-39.9), morbidly obese (≥ 40). Primary outcome was live birth rate per transfer (LBR). Secondary outcomes include clinical intrauterine pregnancy (CIUPR), miscarriage rates (MR), and proportion achieving ≥ 1 live birth. Outcomes were adjusted for age, AMH, FSH, PCOS, tubal infertility, and race.
resultsLBR decreased with increasing BMI for all transfers (53.5%, 52.8%, 42.5%, 30.8%, p < 0.001) and single elective euploid transfers (SEETs) (54.2%, 57.8%, 44.5%, 32.3%, p < 0.001). CIUPR showed the same pattern (58.0%, 59.5%, 50.4%, 39.7%; p < 0.001 all transfers; 58.6%, 63.1%, 51.0%, 40.3%; p < 0.001 SEETs), as did the proportion of patients achieving at least one birth (72.9%, 68.3%, 65.8%, 51.1%; p = 0.020). MR significantly increased with BMI (7.4%, 11.2%, 15.2%, 22.6%, p<0.001) for all transfers but not for SEETs (7.5%, 8.4%, 12.8%, 20.0%; p = 0.169). Each one-unit increase in BMI was associated with a 3% reduction in odds of live birth (aOR 0.969, 95% CI 0.951-0.987, p<0.001).
conclusionIncreasing BMI is associated with lower LBR and CIUPR, following FET, including SEETs. MR increased with BMI for all FETs, with a similar but non-significant gradient among SEETs. This highlights the importance of considering BMI when counseling patients, particularly those with morbid obesity.
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