Hum. Reprod. Advance Access originally published online on April 7, 2005
Human Reproduction 2005 20(7):1867-1875; doi:10.1093/humrep/deh898
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Effects of subfertility cause, smoking and body weight on the success rate of IVF
1 Department of Obstetrics and Gynaecology, 2 Department of Epidemiology and Biostatistics, Radboud University Nijmegen Medical Centre, 3 TNO Nutrition and Food Research, Department of Food & Chemical Risk Analysis, Zeist, 4 Erasmus Medical Centre Rotterdam, Department of Gynaecology and Obstetrics, Rotterdam, 5 Diaconessenhuis, Department of Gynaecology, Reinier de Graaf Groep, Voorburg, 6 Netherlands Cancer Institute, Department of Epidemiology, Amsterdam, The Netherlands
7 To whom correspondence should be addressed. Email: a.lintsen{at}obgyn.umcn.nl
BACKGROUND: We investigated the separate and combined effects of smoking and body mass index (BMI) on the success rate of IVF for couples with different causes of subfertility. METHODS: The success rate of IVF was examined in 8457 women. Detailed information on reproduction and lifestyle factors was combined with medical record data on IVF treatment. All IVF clinics in The Netherlands participated in this study. The main outcome measures were live birth rate per first cycle of IVF differentiated for the major predictive factors. RESULTS: For male subfertility the delivery rate per cycle was significantly lower than unexplained subfertility, OR of 0.70 (95% CI 0.57–0.86); for tubal pathology, the delivery rate was slightly lower, OR = 0.86 (95% CI 0.70–1.01). Smoking was associated with a significantly lower delivery rate was slightly lower; for OR = 0.72 (95% CI 0.61–0.84) and a significantly higher abortion rate compared to non-smoking delivery rates of 21.4% and 16.4%, respectively (P=0.02). Women with a BMI of 
27 kg/m2 had a significantly lower delivery rate, with an OR of 0.67 (95% CI 0.48–0.94), compared with normal weight women (BMI 20 and <27 kg/m2). CONCLUSIONS: Both smoking and overweight unfavourably affect the live birth rate after IVF. The devastating impact of smoking on the live birth rate in IVF treatment is comparable with an increase in female age of >10 years from age 20 to 30 years. Subfertile couples may improve the outcome of IVF treatment by lifestyle changes.
Key words: body mass index/IVF/live birth rate/smoking/subfertility diagnosis
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