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Does Metabolic Status Associate With IVF Outcomes in Women Within Similar Body Mass Index Category: Evidence From a Large Cohort Study

J Diabetes. 2025 Aug;17(8):e70132. doi: 10.1111/1753-0407.70132.

ABSTRACT

OBJECTIVES: Whether diverse metabolic statuses within a similar body mass index (BMI) category associate with different in vitro fertilization (IVF) outcomes.

DESIGN: A retrospective cohort study.

SETTING: Wenzhou, Zhengjiang Province, China.

POPULATION: This retrospective cohort study prescreened 16 458 women who underwent their first IVF and fresh embryo transfer cycle between January 2010 and December 2021.

METHODS: Metabolic status was assessed using the National Cholesterol Education Program-Adult Treatment Panel III criteria. Patients were then categorized into six groups: metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy overweight, metabolically unhealthy overweight, metabolically healthy obese, and metabolically unhealthy obese.

MAIN OUTCOME MEASURES: The primary outcome was live birth rate.

RESULTS: Regarding live birth, rates in normal weight women were initially lower for metabolically unhealthy normal weight versus metabolically healthy normal weight (44.6% vs. 48.6%), but this was not significant after multivariate adjustment. In obese women, live birth rates were similar between metabolically unhealthy obese and metabolically healthy obese (41.5% vs. 43.9%), with no adjusted difference. For secondary outcomes, metabolically unhealthy normal weight patients had lower biochemical pregnancy rates than metabolically healthy normal weight (OR: 0.86, 95% CI: 0.76-0.98); high blood pressure was a significant risk factor for this outcome in metabolically unhealthy normal weight (OR: 0.84, 95% CI: 0.72-0.98).

CONCLUSION: Our findings indicated that different cardio-metabolic risk factors but a similar BMI category may have limited adverse effects on live birth rate.

PMID:40751359 | DOI:10.1111/1753-0407.70132

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