P-683 Do we need Ethnicity-Specific BMI Cut-Offs for IVF success when comparing Asians and Europeans?
Notice bibliographique
Résumé
Abstract Study question Is the BMI cut-off for decreased live birth rates (LBRs) conceived by in-vitro fertilization (IVF) lower in Asian populations compared to European populations? Summary answer In both Asian and European populations, BMI≥23 kg/m² (the overweight threshold in Asian populations) was not associated with a significant decrease in LBRs. What is known already Asian populations often exhibit unique metabolic characteristics, including a higher prevalence of insulin resistance and the metabolic syndrome, which could impact IVF pregnancy outcomes. Asians are considered overweight and experience insulin resistance at a BMI≥23.0kg/m2, whereas Caucasians are classified as overweight at BMI≥25.0kg/m2 and exhibit similar rates of insulin resistance as Asians at BMIs of 23.0kg/m2. In large studies IVF success rates decrease once the BMI≥25.0kg/m2. It is possible that Asians may have IVF success rates that are lower at their ethnicity related overweight cut-offs, but it has yet to be studied. Study design, size, duration This is a retrospective cohort study analyzing data from IVF/ICSI cycles performed between 2015-2017 at two centres, one in Asia (N = 5848) and one in Europe (N = 4463). The study aimed to evaluate the impact of BMI and ethnicity on IVF reproductive outcomes. Participants/materials, setting, methods Participants included women undergoing an IVF/ICSI cycles followed by a fresh embryo transfer. The primary outcome was LBR. Data was analyzed by chi-squared tests, t-tests and a multivariable logistic regression controlling for confounders. Initially data was analyzed using BMI grouping considered normal weight (20.0-24.9kg/m2), overweight (25.0-29.9kg/m2) and obese (≥30kg/m2) by non-ethnicity-specific cut-offs. Subsequently, analyses were conducted using BMI cut-offs of 20.0-22.99 kg/m2 vs. 23.0-24.99 kg/m2, representing normal vs. overweight BMI thresholds in Asian populations. Main results and the role of chance Europeans were heavier than Asians (BMI 25.9±4.7 vs 21.5±2.2 kg/m2, p < 0.001), younger, with lower antral follicle counts (AFCs), stimulated with less gonadotropins, had less oocytes, MII oocytes, 2PN embryos, and transferable embryos (P < 0.001, all). Multivariable logistic regression adjusted for the baseline characteristics of female and male age, AFC, gonadotropins used, sperm source, and duration of infertility to calculate adjusted odds ratios (aORs). When comparing European normal weight (BMI 20.0-24.9kg/m2) (680/2033, 33.4%), to overweight (BMI 25-29.9kg/m2) (406/1574, 26.8%) and to obese (BMI ≥30kg/m2) (211/856, 24.6%), LBRs decreased (P < 0.001) and this was maintained when controlling for confounders (aOR=0.8, 95%, CI:0.7-0.9). When comparing Asian normal weight (BMI 20.0-24.9kg/m2) (879/5282, 16.6%), to overweight (BMI 25-29.9kg/m2) (89/514, 17.3%) and to obese (BMI ≥30kg/m2) (5/52, 9.6%%), LBRs were similar (P = 0.36) which remained when controlling for confounders (aOR=0.60, 95% CI:0.24-1.52). When stratifying patients by BMI 20.0-22.99kg/m2 vs. 23.0-24.99kg/m2, representing normal vs. overweight BMI cut-offs in an Asian population, there was no difference in LBRs in the Europeans (389/1126, 34.5% vs. 291/907, 32.1%, p = 0.24) or the Asians (706/4233, 16.7% vs. 173/1049, 16.5%, p = 0.88). When performing multivariable logistic regression, these BMI groupings were not a significant predictor of LBR in Europeans (aOR=0.92, 95% CI:0.78-1.10) or Asians (aOR=1.02, 95% CI:0.85-1.23). Limitations, reasons for caution The European populations in this study may not have been homogeneous, potentially including ethnicities besides Caucasians. Therefore, some participants in the European cohort may have been of Asian or African ethnicity. Additionally, the small sample size of the obese Asian subgroup may limit the generalizability of the study findings. Wider implications of the findings BMI may be a less reliable predictor of live birth rates (LBRs) in Asians than in Europeans. Asian cut-offs for overweight failed to affect LBR in Europeans or Asians. Trial registration number No
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».