Taraneh Gharib Nazem’s research while affiliated with Reproductive Medicine Associates of New York and other places

Objective To determine the relationship between patients with a low body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and in vitro fertilization (IVF) outcomes following frozen‐thawed embryo transfer (FET). Methods Retrospective cohort study including 12 618 women aged 20–46 years with an underweight (<18.5) or normal weight (18.5–24.9) BMI who underwent controlled ovarian stimulation for IVF in a private and academic IVF center between August 2002 and December 2019. Results Anti‐Müllerian hormone, peak estradiol levels, number of MII oocytes, and fertilized oocytes were greater in the underweight group compared with the normal weight group. The total required gonadotropin dose was lower in the underweight patients compared with the normal weight patients. MII, fertilization, blastulation, and euploid rates did not differ before and after adjusting for confounders between BMI groups. In a cohort of 316 patients who underwent preimplantation genetic testing for aneuploidy and single euploid FET, pregnancy loss, pregnancy, clinical pregnancy, and live birth rates before and after controlling for covariates were similar between groups. Conclusion Although there are known fetal growth or obstetrical issues associated in patients with a low BMI, it is reassuring that these risks do not extend to embryologic or clinical outcomes from IVF treatment.

Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse, or after 6 months among women over 35 years of age. This chapter provides the background and causes of infertility in the infertile couple. Fecundability for healthy young couples is estimated to be 0.25, meaning there is a 75% chance of failure to conceive in one cycle. However, this rate declines with each consecutive unsuccessful cycle and can reach 0.03 by 12 months. The first step in determining the cause of infertility is to obtain a thorough history and physical exam. Diagnostic testing should focus on confirming tubal patency and evaluating the female reproductive tract, including the uterine cavity. Ovarian reserve testing should be considered particularly in women >35 years of age. The differential diagnosis and clinical diagnosis of the condition is also presented.