Obesity and its metabolic complications in IVF Veronika U. Smolnikovaa, Victoria K. Gorshinovaa, Daria V. Tsvirkuna, Iuliia A. Sukhanovaa,b, Nadezhda V. Tarasovaa, Maria A. Volodinaa, Elena A. Kalininaa, Mikhail Yu. Vysokikha,b, Gennady T. Sukhikha a Federal State Budget Institution “Research Center for Obstetrics, Gynecology and Perinatology”, Ministry of Healthcare of the Russian Federation, 4 Oparina street, Moscow, Russian Federation 117997 b Belozerskii Institute of Physico-chemical Biology, Moscow State University, Moscow, Leninskie gory 1, 119992, Russian Federation

Taking into account the data about the regulatory effect of adipokines on all levels of the reproductive system, we aim to assess proinflammatory state and its correlation with oocyte quality, fertilization rate and early embryogenesis in obese and normal weight women who underwent ovarian stimulation using IVF protocols.

P – level of significance Main treatment characteristics in IVF program according to female BMI Variable Group 1 (BMI 18,5-24,99 kg/m2)   Group 2 (BMI 25,0-29,99 kg/m2) Group 3 (BMI>30,0 kg/m2) P – level of significance Total dose of gonadotropins (IU) * 1350,0 (1175,0-1537,5) # 1350,0 (1200,0-1650,0) 1500,0 (1237,5-1875,0) # 0,023/#- р=0,019 Duration of stimulation (days)* 9,0 (8,5-10,0) # 9,0 (8,0-11,0) 10,0 (9,0-10,5)# 0,02/#- р=0,011 Number of retrieved oocytes* 7,0 (5,0-10,0)# 5,0 (3,0-9,0) 5,0 (2,0-8,5) # 0,043/#- р=0,014 Number of mature oocytes* 6,0 (4,0-8,0) # 4,0 (3,0-8,0) 3,0 (2,0-7,0) # 0,008/#- р=0,002 Dose of gonadotropins injected per oocyte retrieved* 187,5 (143,1-340,0) # 257,1 (159,4-400,0) 330,0 (173,2-662,5) # 0,009/#- р=0,004 Dose of gonadotropins injected per mature oocyte retrieved * 217,5 (159,7-412,5) # 318,8 (173,1-562,5) 431,3 (262,5-712,5) # 0,002/#- р=0,001

P – level of significance Characteristics of early embryogenesis and treatment outcomes in women in the study groups Variable Group 1 (BMI 18,5-24,99 kg/m2) Group 2 (BMI 25,0-29,99 kg/m2) Group 3 (BMI>30,0 kg/m2) P – level of significance   Number of obtained zygotes (per 1 patient) * 6 (3-7)# 4 (2-7) 3 (2-5)# 0,022/#- р=0,006 Fertilization rate (%)** 78,1% # 76,6% 71,2% # p =0.02 Number of embryos to transfer * 2 (2-2) 1,000 Clinical pregnancy rate** 43,1% (31) 30,8% (12) 28,6% (14) 0,202 Implantation rate ** 30,2%# 20,8% 15,9%# 0,037//#- р=0,016 Live birth rate** 30,6% (22) 23,1% (9) 16,3% (8) 0,056 Number of cycles in which embryo cryopreservation was performed ** 41% (16) 0,249

Morphological quality of embryos on day 5 of cultivation among study groups

Correlations of adipokine levels in blood plasma with BMI.

Morphological evaluation of 5th day embryos and level of adipokines in the blood plasma р=0,001 p = 0.002 р=0,007 р=0,015

BMI=28,5 kg/m2

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