Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome

Objective: To determine whether morbid obesity is associated with decreased pregnancy and live birth rates after IVF in women with polycystic ovary syndrome (PCOS). Design: Retrospective cohort study. Setting: University-based fertility center. Patient(s): Seventy-two women with PCOS who completed their first IVF cycle between 2001 and 2006. Intervention(s): Outcomes of IVF were compared between women with a body mass index (BMI) of <40 kg/m(2) vs. those with a BMI of >= 40 kg/m(2). Main Outcome Measure(s): Clinical pregnancy rate, live birth rate. Result(s): Morbidly obese women with PCOS (n = 19) had significantly lower clinical pregnancy rates after IVF than patients with PCOS who were not morbidly obese (n = 53) (32% vs. 72%, relative risk 0.44, 95% confidence interval 0.22-0.87). Their live birth rates were lower too, although this difference was not statistically significant (32% vs. 60%, relative risk 0.52, 95% confidence interval 0.26-1.05). Conclusion(s): Morbid obesity is associated with lower pregnancy rates in women with PCOS after IVF, raising the question of whether weight loss may improve IVF success rates for morbidly obese PCOS patients. (Fertil Steril (R) 2009;92:256-61. (C) 2009 by American Society for Reproductive Medicine.)