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Saar-Ryss B, Shilo M, Friger M, Grin L, Michailov Y, Meltcer S, Zaks S, Rabinson J, Lazer T, Friedler S. Is there any truth in the myth that IVF treatments involve weight gain? FRONTIERS IN REPRODUCTIVE HEALTH 2024; 5:1327110. [PMID: 38260051 PMCID: PMC10800931 DOI: 10.3389/frph.2023.1327110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose To examine body weight change in women undergoing in vitro fertilization and embryo transfer (IVF-ET) using antagonist protocol after up to three treatment cycles. Methods A prospective cohort study among IVF patients treated between 2018 and 2019. Each patient underwent weight measurement three times during the treatment cycle: before treatment, at the beginning of the hormonal stimulation, and at the completion of the cycle, on the day of the pregnancy test. Data were also analyzed according to the body mass index (BMI) groups for normal weight, overweight, and obese patients. Finally, weight changes were recorded following altogether 519 treatment cycles, 240, 131, and 148 cycles, for normal weight, overweight, and obese patients, respectively. Results The change in the patient's weight was clinically non-significant either during the waiting period or during gonadotropin administration, and overall, during the first, second, or third treatment cycles. The recorded mean total weight change of 0.26 ± 1.85, 0.4 ± 1.81, and 0.17 ± 1.7, after the first, second, or third treatment cycles, represent a change of 0.36%, 0.56%, and 0.23% of their initial weights, respectively. This change of less than 1% of the body weight falls short of the clinically significant weight gain of 5%-7%. Analyzing the data for the various BMI groups, the changes observed in body weight were under 1%, hence with no clinical significance. Conclusion The findings of the study reject the myth that hormone therapy involves clinically significant weight gain, and this can lower the concerns of many patients who are candidates for treatment of assisted reproductive technology.
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Affiliation(s)
- Bozhena Saar-Ryss
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Shilo
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michael Friger
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Leonti Grin
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yulia Michailov
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Simion Meltcer
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
| | - Svetlana Zaks
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Jacob Rabinson
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
| | - Tal Lazer
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shevach Friedler
- IVF Unit, Barzilai University Medical Center, Ashkelon, Israel
- Facultyof Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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2
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Evans AT, Vitek WS. Weight Bias in Reproductive Medicine: A Curiously Unexplored Frontier. Semin Reprod Med 2023; 41:63-69. [PMID: 37992727 DOI: 10.1055/s-0043-1777016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Obesity has been associated with a multitude of medical comorbidities, infertility, and adverse obstetric outcomes. Weight stigma and weight bias pervade not only the medical field but also education, employment, and activities of daily living. The experience of weight stigma has been shown to adversely impact not only the mental health of individuals with overweight or obesity but also worsen obesogenic behaviors, and medical comorbidities. This review frames the rise of weight stigma and weight bias within the context of the "obesity epidemic" and explores its associations with infertility and decreased access to health care and its subsequent impact on the lives of individuals. Furthermore, it explores the concepts of intrinsic and extrinsic weight stigma/bias and highlights the need for further examination and research into the impact of these factors on access to reproductive medicine and subsequent outcomes.
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Affiliation(s)
- Adam T Evans
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
| | - Wendy S Vitek
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
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3
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Margiana R, Lestari SW, Narulita P, Jusuf AA, Ima K. Dietary Soybean (Glycine max (L.) Merr.) Improved the ZP2 Expression in Female Swiss Mice. JBRA Assist Reprod 2023; 27:147-155. [PMID: 35916458 PMCID: PMC10279445 DOI: 10.5935/1518-0557.20220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/01/2022] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE This study aimed to determine the effects of soybean (Glycine max) administration on ZP2 expression in female mice. METHODS This research used Mus musculus, six-week-old female SWISS strain mice divided into three groups (group without soybean administration and groups with mixed feed with soybeans and pelleted 50:50 and 25:75). Soybean feed for mice was 360 grams per kilogram of mouse body weight for 2 weeks. The percentage of follicles was measured and analyzed using Hematoxylin-Eosin staining, and the expression of ZP2 was analyzed using immunohistochemistry. We assessed the data using one-way ANOVA and paired t-test using the SPSS 17. RESULTS Some of the follicles in the ovaries do not develop until their final stage of follicle maturation. The administration of soybean before and after treatment in all groups was not significantly different, but the numbers of atretic follicles in groups 1 and 2 were significantly different. Soybean administration at a ratio of 50:50 has the effect of increasing the percentage of the ZP2 expression in tertiary follicles (p=0.001), whereas soybean administration at a ratio of 25:75 was not able to maintain or increase the formation of ZP2 in tertiary follicles (p=0.77). CONCLUSION Soybean administration with a ratio of 50:50 significantly increased the percentage of the ZP2 expression in tertiary follicles.
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Affiliation(s)
- Ria Margiana
- Department of Anatomy, Faculty of Medicine, Universitas
Indonesia, Indonesia
- Master’s Programme in Biomedical Science, Faculty of Medicine,
Universitas Indonesia, Indonesia
- Research Biobank, Faculty of Medicine, Universitas Indonesia,
Indonesia
- Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas
Indonesia, Indonesia
- Department of Medical Biology, Faculty of Medicine, Universitas
Indonesia, Indonesia
- Departement of Histology, Faculty of Medicine, Universitas
Indonesia
| | - Silvia Werdhy Lestari
- Department of Medical Biology, Faculty of Medicine, Universitas
Indonesia, Indonesia
| | - Pety Narulita
- Andrology Program, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ahmad Aulia Jusuf
- Departement of Histology, Faculty of Medicine, Universitas
Indonesia
| | - Khoirul Ima
- Master’s Programme in Biomedical Science, Faculty of Medicine,
Universitas Indonesia, Indonesia
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4
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Ennab F, Atiomo W. Obesity and female infertility. Best Pract Res Clin Obstet Gynaecol 2023; 89:102336. [PMID: 37279630 DOI: 10.1016/j.bpobgyn.2023.102336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 03/30/2023] [Indexed: 06/08/2023]
Abstract
Infertility is a significant global health issue, with a negative impact on people's wellbeing and human rights. Despite the longstanding association between obesity and infertility, there remains uncertainty, about the precise mechanisms underpinning this association and best management strategies. In this article, we aimed to address these uncertainties by reviewing the recent literature, and focusing on studies which evaluated live birth rates. We found that just over half of the studies, investigating the relationship between preconception maternal weight and live birth rates found an inverse correlation. There was, however, insufficient evidence, that preconception maternal lifestyle or pharmacological interventions in obese women with infertility, resulted in improved live birth rates. The implications for clinical practice and future research are highlighted. For example, the need to consider some flexibility in applying strict preconception body mass index targets, limiting access to fertility treatment, and a need for large clinical trials of new pharmacological options and bariatric surgery.
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Affiliation(s)
- Farah Ennab
- College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Al Razi St., Umm Hurair 2, Dubai Healthcare City, P.O. Box 505055, Dubai, United Arab Emirates.
| | - William Atiomo
- College of Medicine, Mohammed Bin Rashid University of Medicine, and Health Sciences, Building 14, Al Razi St., Umm Hurair 2, Dubai Healthcare City, P.O. Box 505055, Dubai, United Arab Emirates.
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Ghobrial S, Parry JP, Holzer I, Aschauer J, Selzer C, Brezina A, Helmy-Bader S, Ott J. The Prevalence of Fallopian Tube Occlusion in Women with Polycystic Ovary Syndrome Seems Similar to Non-Subfertile Women: A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11195610. [PMID: 36233477 PMCID: PMC9572298 DOI: 10.3390/jcm11195610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
There are limited data on how non-infectious risk factors influence tubal patency in women with subfertility. With hormonal shifts influencing tubal secretions, it has been argued that subfertile women with polycystic ovary syndrome (PCOS) have lower tubal patency. In a retrospective study, 216 women, who underwent diagnostic evaluation for PCOS and infertility, were included. Fallopian tube patency was tested using HSG, HyCoSy, and laparoscopic chromopertubation in 171 (79.2%), 28 (13.0%), and 17 (7.9%), respectively. Bilateral patency was found in 193 women (89.4%), unilateral patency in 13 (6.0%) and bilateral occlusion in 10 (4.6%) patients. Women with PCOS phenotypes C (odds ratio, OR 0.179, 95% CI: 0.039–0.828) and D (OR 0.256, 95% CI: 0.069–0.947) demonstrated lower risks for Fallopian tube occlusion. In conclusion, our data suggest that about 5% of infertile women with PCOS also have bilateral tubal occlusion, which seems similar to the rate in non-subfertile women. With 11% of participants having unilateral or bilateral tubal occlusion, this should reassure women with PCOS that their hormonal challenges do not seem to increase their risk for tubal factor subfertility.
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Affiliation(s)
- Stefan Ghobrial
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - John Preston Parry
- Parryscope and Positive Steps Fertility, Madison, WI 39110, USA
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Iris Holzer
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Judith Aschauer
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Clara Selzer
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Samir Helmy-Bader
- Clinical Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-28130
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Bajaj SS, Jain B, Stanford FC. Weight gain after in vitro fertilization: a potential consequence of controlled ovarian stimulation. J Assist Reprod Genet 2022; 39:973-976. [PMID: 35218460 PMCID: PMC9051006 DOI: 10.1007/s10815-022-02444-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 11/26/2022] Open
Abstract
In the USA, 42% of adult women were estimated to have obesity, and 13% of women of childbearing age similarly have impaired fecundity. Obesity is associated with infertility such that patients with obesity often seek out in vitro fertilization (IVF) services. Here, we report on the case of a woman with childhood-onset class II obesity who had been undergoing treatment with phentermine and topiramate prior to undergoing 3 cycles of IVF. With each cycle, the patient temporarily gained 13-15 lbs. during controlled ovarian stimulation (COS). Weight gain from COS may be clinically relevant and merits further study to optimize weight status across women's reproductive life and to better assist women who gain weight secondary to IVF. Incorporating weight monitoring into IVF protocols may also help better characterize the scope of weight gain from COS.
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Affiliation(s)
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Fatima Cody Stanford
- MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, 50 Staniford Street, Boston, MA, 02114, USA.
- Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), 4th Floor, Weight Center, 50 Staniford Street, Boston, MA, 02114, USA.
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Boots CE, Swanson AC, Jungheim ES. Infertility: a weight-bearing exercise? Fertil Steril 2020; 114:964-965. [PMID: 32892997 DOI: 10.1016/j.fertnstert.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Christina E Boots
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amelia C Swanson
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Emily S Jungheim
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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