Higher preconceptional maternal body mass index is associated with faster early preimplantation embryonic development: the Rotterdam periconception cohort

• Published in: Reproductive biology and endocrinology Vol. 19; no. 1; p. 145
• Main Authors: van Duijn, Linette, Rousian, Melek, Hoek, Jeffrey, Willemsen, Sten P, van Marion, Eva S, Laven, Joop S E, Baart, Esther B, Steegers-Theunissen, Régine P M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.09.2021; BioMed Central; BMC
• Subjects: Adult; Algorithms; Blastocyst - physiology; Body Mass Index; Body weight; Clinical outcomes; Cohort Studies; Embryo development; Embryo Implantation - physiology; Embryogenesis; Embryonic development; Embryonic Development - physiology; Embryos; Female; Fertility; Fertilization; Fertilization - physiology; Fertilization in Vitro; Gene expression; Humans; Implantation; In vitro fertilization; Infertility - epidemiology; Infertility - therapy; Medical records; Morphokinetics; Mothers; Netherlands - epidemiology; Obesity; Obesity - epidemiology; Obesity - physiopathology; Ovaries; Overweight; Overweight - epidemiology; Overweight - physiopathology; Pregnancy; Pregnancy Outcome - epidemiology; Preimplantation; Retrospective Studies; Sperm; Sperm Injections, Intracytoplasmic; Statistics; Time-lapse; Womens health; Netherlands; Body mass index; Morphokinetics; Preimplantation; Time-lapse; Embryo development
• ISSN: 1477-7827; 1477-7827
• DOI: 10.1186/s12958-021-00822-0

Overweight and obesity affect millions of people globally, which has also serious implications for reproduction. For example, treatment outcomes after in vitro fertilisation (IVF) are worse in women with a high body mass index (BMI). However, the impact of maternal BMI on embryo quality is inconclusive. Our main aim is to study associations between preconceptional maternal BMI and morphokinetic parameters of preimplantation embryos and predicted implantation potential. In addition, associations with clinical IVF outcomes are investigated. From a tertiary hospital, 268 women undergoing IVF or IVF with intracytoplasmic sperm injection (ICSI) were included; 143 normal weight, 79 overweight and 46 obese women. The embryos of these women were cultured in the EmbryoScope, a time-lapse incubator. The morphokinetic parameters of preimplantation embryos and predicted implantation potential, assessed by the KIDScore algorithm were longitudinally evaluated as primary and secondary outcomes, respectively. The tertiary outcomes included clinical outcomes, i.e., fertilization, implantation and live birth rate. After adjustment for patient- and treatment-related factors, we demonstrated in 938 embryos that maternal BMI is negatively associated with the moment of pronuclear appearance (β -0.070 h (95%CI -0.139, -0.001), p = 0.048), pronuclear fading (β -0.091 h (95%CI -0.180, -0.003), p = 0.043 and the first cell cleavage (β -0.111 h (95%CI -0.205, -0.016), p = 0.022). Maternal BMI was not significantly associated with the KIDScore and tertiary clinical treatment outcomes. In embryos from couples with female or combined factor subfertility, the impact of maternal BMI was even larger (β -0.170 h (95%CI -0.293, -0.047), p = 0.007; β -0.199 h (95%CI -0.330, -0.067), p = 0.003). Additionally, a detrimental impact of BMI per point increase was observed on the KIDScore (β -0.073 (se 0.028), p = 0.010). Higher maternal BMI is associated with faster early preimplantation development. In couples with female or combined factor subfertility, a higher BMI is associated with a lower implantation potential as predicted by the KIDScore. Likely due to power issues, we did not observe an impact on clinical treatment outcomes. However, an effect of faster preimplantation development on post-implantation development is conceivable, especially since the impact of maternal BMI on pregnancy outcomes has been widely demonstrated.