Female obesity increases the risk of miscarriage of euploid embryos

In this study, 3,480 cycles of in vitro fertilization with preimplantation genetic testing for aneuploidy (PGT-A) in the blastocyst stage and euploid embryo transfer were divided into four groups according to patient body mass index (BMI).

The primary outcome was the miscarriage rate, which included both biochemical and clinical miscarriages. Secondary outcomes were implantation, pregnancy, clinical pregnancy, and live birth rates.
Cycles were divided into four groups according to BMI (kg/m 2): underweight (<18.5; n = 155), normal weight (18.5–24.9; n = 2,549), overweight (25–29.9; n = 591), and obese (≥30; n = 185). The number of PGT-A cycles per patient was similar in the four groups. Fertilization rate, day of embryo biopsy, technique of chromosomal analysis, number of euploid embryos, number of transferred embryos, and method of endometrial preparation for embryo transfer were similar in the four BMI groups. Miscarriage rates were significantly higher in women with obesity compared to women with normal weight, mainly due to a significant increase in the clinical miscarriage rates. Live birth rates also were lower in women with obesity. Obesity in women and day 6 trophectoderm biopsy were found to influence the reduced live birth rate.
Women with obesity experience a higher rate of miscarriage after euploid embryo transfer than women with a normal weight, suggesting that other mechanisms than aneuploidy are responsible for this outcome.

What do you think about “Check your BMI before starting a fertility treatment”?

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Vitamin D is associated with increased likelihood of pregnancy, livebirth and reduced pregnancy loss

vitamin D

Vitamin D deficiency during pregnancy is associated with adverse pregnancy outcomes, although the association between preconception vitamin D concentrations and livebirth is unknown.

The study aimed to assess the association between preconception vitamin D and pregnancy outcomes among women with proven fecundity.

The findings were published in The Lancet Diabetes & Endocrinology and 1191 women had available data on preconception 25-hydroxyvitamin D concentrations.

According to the study sufficient preconception 25-hydroxyvitamin D (≥75 nmol/L) was associated with increased likelihood of pregnancy and livebirth. Increased vitamin D concentrations before conception, but not in early pregnancy, were associated with reduced pregnancy loss.

Conception and Pregnancy after 40

pregnant woman

As women grow older their fertility tends to faint

Nowadays, an increasing number of women consider conception after the age of 40. The incidents of women over 45 year old becoming mothers through assisted conception keep growing.
According to ESHRE, the percentage of women turning to Assisted Reproductive Technology (ART) for making a baby has increased significantly. Over the last 15 years, it is estimated that the number of IVF cycles performed for women 40-45 year old has increased about ten times. This information indicates a drift of more and more women to making a family later in life.
Many women tend to think that as long as they have a period they are perfectly capable of getting pregnant, and this is partly true but not quite. It is correct that every woman, prior menopause, who has a period and ovulates, is possible to achieve pregnancy, even during climacterium; her chances though are quite small.
As women grow older their fertility tends to faint, they tend to have fewer eggs and of poor quality making natural conception less possible, especially after age 42. On the other hand, male fertility is not as age sensitive as the female fertility. A growing body of research reports that men of older age do produce more abnormal sperm and it takes longer for their partners to conceive but the fact is they keep producing sperm their whole lives.
Since a growing number of women now choose to delay pregnancy well into their 40s, let’s summarize a few things that women of advanced reproductive age seeking for an infertility treatment need to take under consideration prior treatment.
Subfertility diagnose: There are a number of fertility treatment options and different IVF protocols developed for serving different needs. Quite often though, couples of advanced age, knowing time is running for them, choose IVF straightway without considering any other treatment options, as it is known for its high success rates. Even though advanced age can be a cause of subfertility there might be other things causing infertility as well, like male factor, endometriosis and more. So finding out the exact cause of infertility is crucial for couples and their physician to decide which treatment benefits them most.
IVF success rates and Egg donation: success rates for women over 40 are dramatically decreased. A recent study reported that women age 40-41 had 15.6% chances of pregnancy following IVF, while for those aged 44 these rates dropped to 1.3%. Egg donation is an effective way for successful IVF for women with poor egg quality. It is a great option for women over 40 who want to boost their pregnancy chances, since success rates with egg donation are high.
Risk of chromosome abnormalities: Babies born to older mothers have a higher risk of certain chromosome problems, such as Down syndrome. Therefore it is critical for women to go through genetic screening tests that will assure the baby’s health.
Risk of miscarriage/pregnancy complications: older women have greater risk for experiencing a miscarriage within the first 3 months due to chromosomal abnormalities or other pregnancy complications later on. That is something that poses some substantial concern for women but being aware of it is necessary in order to be alert and prepared for any outcome.

Are you in favor of a later-in-life pregnancy?