The appraisal of body content (ABC) trial: obesity does not significantly impact gamete production in infertile men and
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REPRODUCTIVE PHYSIOLOGY AND DISEASE
The appraisal of body content (ABC) trial: obesity does not significantly impact gamete production in infertile men and women Julia Kim 1,2 & Caroline Juneau 1 & George Patounakis 3 & Scott Morin 1,2,4 & Shelby Neal 1,2,5 & Emre Seli 1,6 & Richard Scott 1,2 Received: 21 July 2020 / Accepted: 17 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose As obesity becomes increasingly prevalent, its impact on fertility has been a subject of great debate. Nearly all prior research is retrospective and evaluates obesity utilizing body mass index (BMI), which may overestimate adiposity in individuals with a greater amount of lean muscle and underestimate adiposity in those with less muscle mass. Methods We prospectively evaluated 2013 couples undergoing infertility treatment with in vitro fertilization (IVF). Percent body fat (%BF) was measured by use of a bioelectric impedance analysis (BIA) scale at baseline. BMI was also determined. Ovarian reserve parameters, ovarian response to controlled ovarian hyperstimulation, and semen analyses were measured in correlation with their %BF and BMI. Results Females classified as obese based on %BF or BMI had lower serum FSH. However, when the analysis was limited to women without PCOS (n = 1706), obesity based on %BF or BMI was associated with lower serum AMH. Female obesity— regardless of a PCOS diagnosis—did not affect number of mature oocytes retrieved. Males who were in obese %BF category were found to have lower TMSC compared with normal weight counterparts (p < 0.05); however, the observed decrease was not significant enough to limit the success of assisted reproductive technologies. Conclusions These findings suggest that while obesity may affect ovarian reserve in women variably depending on presence of PCOS, it does not affect number of mature oocytes available after COH. Similarly, while a high %BF in males is associated with lower TMSC, the observed difference is unlikely to affect IVF outcomes. Keywords Obesity . Adiposity . Male infertility . Female infertility
Introduction Obesity is a global epidemic that has worsened in severity over the past several decades [1]. This disease not only represents a major risk factor for cardiovascular disease, cancer, and diabetes mellitus, but the World Obesity Federation also * Julia Kim [email protected] 1
IVI RMA New Jersey, Basking Ridge, NJ, USA
2
Sidney Kimmel Medical School of Jefferson University, Philadelphia, PA, USA
3
IVI RMA Florida, Lake Mary, FL, USA
4
IVI RMA of Northern California, San Francisco, CA, USA
5
Wake Forest School of Medicine, Wake Forest, NC, USA
6
Yale School of Medicine, New Haven, CT, USA
declared obesity to be its own entity as a chronic progressive disease [2]. Besides increased morbidity and mortality, obesity has been found to lead to social stigma and also imposes increased economic burden [3, 4]. Nowhere is this more urgent or prevalent than in the USA where 42.8% of the adult population was obese (body mas
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