Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
J Nutr. 2021 Mar 11;151(3):649-656. doi: 10.1093/jn/nxaa371.
Overweight and obesity among women have been associated with lower success of assisted reproduction technologies (ARTs). However, the relation of adolescent body weight and adult weight change to ART outcomes is not well understood.
Our objective was to evaluate the associations of female BMI (in kg/m2) at 18 y and weight change from 18 y to current age with ART outcomes.
We included 486 women in a prospective cohort at the Massachusetts General Hospital Fertility Center (2004-2018) who underwent 863 ART cycles. At study entry, height and weight were measured by research personnel. Women recalled their weight at 18 y. Restricted cubic splines were used to evaluate the associations between BMI at 18 y and weight change since 18 y and ART outcomes adjusting for age, race, education, smoking, and height and accounting for the correlated cycles within women.
Women had a median (range) BMI of 20.6 (14.8 to 36.4) at 18 y and 23.3 (16.1 to 45.8) at study entry. The median (range) weight change since 18 y was 7.4 kg (-12.1 to 60.1 kg). There was no association between BMI at 18 y and clinical ART outcomes. Long-term weight change had a nonlinear association with live birth such that higher weight gain since 18 y (particularly ≥15 kg) and weight loss were both associated with lower odds of live birth. The negative association between weight change and live birth was stronger in women ≥22.5 kg/m2 at 18 y such that each 10-kg increase was associated with a 30% (6%, 48%) lower odds of live birth.
Weight gain in adulthood is negatively associated with ART success, particularly among women who were heavier at 18 y. These results add to the growing literature supporting the benefits of preventing weight gain in adulthood on female fertility.
超重和肥胖与女性辅助生殖技术（ART）的成功率降低有关。然而，青少年体重和成年后体重变化与 ART 结果的关系尚不清楚。
本研究旨在评估女性 18 岁时 BMI（kg/m2）和 18 岁后体重变化与 ART 结局的关系。
我们纳入了 2004 年至 2018 年在马萨诸塞州总医院生育中心进行的前瞻性队列研究中的 486 名女性，共进行了 863 个 ART 周期。在研究入组时，由研究人员测量身高和体重。女性回忆自己 18 岁时的体重。使用限制立方样条来评估 18 岁时 BMI 和 18 岁后体重变化与 ART 结局之间的关系，调整年龄、种族、教育程度、吸烟情况以及女性内相关周期。
女性 18 岁时的 BMI 中位数（范围）为 20.6（14.8 至 36.4），入组时为 23.3（16.1 至 45.8）。18 岁后体重中位数（范围）变化为 7.4kg（-12.1 至 60.1kg）。18 岁时 BMI 与临床 ART 结局无关。长期体重变化与活产呈非线性关系，即 18 岁后体重增加（尤其是≥15kg）和体重减轻均与活产几率降低相关。体重变化与活产的负相关在 18 岁时 BMI≥22.5kg/m2 的女性中更强，每增加 10kg，活产几率降低 30%（6%，48%）。
成年后体重增加与 ART 成功呈负相关，尤其在 18 岁时体重较重的女性中。这些结果增加了越来越多的支持成年期预防体重增加对女性生育力有益的文献。
