Background
Many studies have documented a lower likelihood of live birth with increasing body
mass index among women undergoing assisted reproductive technology, but few have examined
the association with waist circumference, an anthropometric measure that allows assessment
of central adiposity.
Objective
To examine the relation between baseline waist circumference and infertility treatment
outcomes among women undergoing treatment with assisted reproductive technology.
Materials and Methods
We followed up 264 women who underwent 445 assisted reproductive technology cycles
for infertility treatment at the Massachusetts General Hospital between 2010 and 2017.
Waist circumference was assessed at enrollment. We used cluster-weighted generalized
estimating equation models to estimate the probability of live birth by tertiles of
waist circumference (<77, 77–86, >86 cm), while accounting for multiple treatment
cycles per woman and adjusting for age, race, smoking, infertility diagnosis, day
3 follicle-stimulating hormone, body mass index, and height.
Results
Mean (standard deviation) waist circumference and body mass index were 83.6 (12.6)
cm and 24.1 (4.3) kg/m2, respectively. Waist circumference and body mass index were positively correlated
(r = 0.69, P < .0001). Waist circumference was inversely related to the probability of live birth
after adjusting for BMI and other confounders. The multivariable adjusted probability
of live birth (95% confidence interval) for women in increasing tertiles of waist
circumference were 53% (42–65%), 42% (32–53%), and 38% (28–50%) (P, trend = .04). When women were classified in joint categories of body mass index
and waist circumference, women with a body mass index ≥25 kg/m2 and a waist circumference ≥77 cm had the lowest live birth rate (38% [27–50%]), whereas
women with a body mass index between 18.5 and 25 kg/m2 and a waist circumference <77 cm had the highest (54% [42–66%]). The results were
similar using different waist circumference cut-off values.
Conclusion
Waist circumference was inversely related to the probability of live birth among women
undergoing assisted reproductive technology independently of body mass index.
Key words
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Article Info
Publication History
Published online: February 11, 2019
Accepted:
February 5,
2019
Received in revised form:
January 7,
2019
Received:
September 9,
2018
Footnotes
The authors report no conflict of interest.
Supported by Grants P30ES000002, R01ES009718, R01ES022955, and P30DK046200 from the National Institutes of Health . Dr. Li was supported by the Ministry of Science and Technology, Taiwan (MOST 106-2917-I-564-066 ).
Cite this article as: Li M-C, Mínguez-Alarcón L, Arvizu M, et al. Waist circumference in relation to outcomes of infertility treatment with assisted reproductive technologies. Am J Obstet Gynecol 2019;220:578.e1-13.
Identification
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