Einarsson S, et al. – A randomized controlled trial was carried out to explore the effect of weight reduction intervention for obese infertile women prior to in vitro fertilization (IVF). An intensive weight reduction programme resulted in a large weight loss but did not substantially influence live birth rates in obese women scheduled for IVF.

Methods

• For this study, they designed a prospective, multicentre, randomized controlled trial.
• This study was performed between 2010 and 2016 in the Nordic countries.
• In total, 962 women were evaluated for eligibility and 317 women were randomized.
• Computerized randomization with concealed allocation was performed in the proportions 1:1 to one of two groups: weight reduction intervention followed by IVF–treatment or IVF–treatment only.
• One cycle per patient was included. In this study, total Nine infertility clinics in Sweden, Denmark and Iceland participated.
• Women under 38 years of age planning IVF, and having a BMI ≥ 30 and <35 kg/m² were randomized to two groups: an intervention group (160 patients) with weight reduction before IVF, starting with 12 weeks of a low calorie liquid formula diet (LCD) of 880 kcal/day and thereafter weight stabilization for 2–5 weeks, or a control group (157 patients) with IVF only.

Results

• In the full analysis set (FAS), the live birth rate was 29.6% (45/152) in the weight reduction and IVF group and 27.5% (42/153) in the IVF only group.
• The difference was not statistically significant (difference 2.2%, 95% CI: 12.9 to –8.6, P = 0.77).
• The mean weight change was –9.44 (6.57) kg in the weight reduction and IVF group as compared to +1.19 (1.95) kg in the IVF only group, being highly significant (P < 0.0001).
• Significantly more live births were achieved through spontaneous pregnancies in the weight reduction and IVF group, 10.5% (16) as compared to the IVF only group 2.6% (4) (P = 0.009).
• Miscarriage rates and gonadotropin dose used for IVF stimulation did not differ between groups.
• Two subgroup analyses were performed.
• The first compared women with PCOS in the two randomized groups, and the second compared women in the weight reduction group reaching BMI ≤ 25 kg/m or reaching a weight loss of at least five BMI units to the IVF only group.
• No statistical differences in live birth rates between the groups in either subgroup examination were found.