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Hum. Reprod. Advance Access originally published online on December 11, 2007
Human Reproduction 2008 23(2):324-328; doi:10.1093/humrep/dem371
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women

Jan Willem van der Steeg1,2,4,8, Pieternel Steures1,2,4, Marinus J.C. Eijkemans1, J. Dik F. Habbema1, Peter G.A. Hompes4, Jan M. Burggraaff5, G. Jur E. Oosterhuis6, Patrick M.M. Bossuyt3, Fulco van der Veen2 and Ben W.J. Mol2,7

1 Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, The Netherlands 2 Center for Reproductive Medicine, Academic Medical Centre, Amsterdam, The Netherlands 3 Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, Amsterdam, The Netherlands 4 Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands 5 Department of Obstetrics and Gynaecology, Scheperziekenhuis Emmen, Emmen, The Netherlands 6 Department of Obstetrics and Gynaecology, Medisch Spectrum Twente, Enschede, The Netherlands 7 Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands

8 Correspondence address. Academic Medical Centre, Centre for Reproductive Medicine, Room H4-213, PO Box 22660, 1105 AZ Amsterdam, The Netherlands. Tel: +31-20-5663857; Fax: +31-20-6963489; E-mail: j.w.vandersteeg{at}amc.uva.nl

BACKGROUND: Obesity is increasing rapidly among women all over the world. Obesity is a known risk factor for subfertility due to anovulation, but it is unknown whether obesity also affects spontaneous pregnancy chances in subfertile, ovulatory women.

METHODS: We evaluated whether obesity affected the chance of a spontaneous pregnancy in a prospectively assembled cohort of 3029 consecutive subfertile couples. Women had to be ovulatory and had to have at least one patent tube, whereas men had to have a normal semen analysis. Time to spontaneous ongoing pregnancy within 12 months was the primary endpoint.

RESULTS: The probability of a spontaneous pregnancy declined linearly with a body mass index (BMI) over 29 kg/m2. Corrected for possible related factors, women with a high BMI had a 4% lower pregnancy rate per kg/m2 increase [hazard ratio: 0.96 (95% CI 0.91–0.99)].

CONCLUSIONS: These results indicate that obesity is associated with lower pregnancy rates in subfertile ovulatory women.

Key words: obesity/subfertility/pregnancy chance/spontaneous conception

Submitted on February 8, 2007; resubmitted on September 18, 2007; accepted on September 26, 2007.


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