Body mass index and fertility: is there a correlation with human reproduction outcomes?

Considering the existing conflicts about how an elevated body mass index (BMI) affects fertility, this study had the objective of evaluating the impact of overweight and obesity on the results of IVF/ICSI (in-vitro fertilisation/intracytoplasmatic sperm injection) performed at the Human Reproduction Centre of Faculdade de Medicina do ABC. Retrospective data from 208 IVF cycles of 191 women, performed at our laboratory from February through June, 2008, were used to calculate their BMI. On the basis of the results, the patients were divided into two groups: Group 1: BMI <25 kg/m(2) and Group 2: BMI ≥ 25 kg/m(2). Of the 208 cycles, 137 were from patients with BMI <25 kg/m(2) and 71 cycles from patients with BMI ≥ 25 kg/m(2). Patients' ages and the number of cycles with gonadotrophin-releasing hormone agonist and antagonist were similar in both groups. The doses of follicle-stimulating hormone used for ovarian induction per cycle, the number of retrieved oocytes, fertilisation rate, embryo quality and number of transferred and frozen embryos, the hyperstimulation, pregnancy rates, miscarriage rate and live birth rates showed no statistically significant differences. BMI does not appear to be a good parameter for the definition of IVF success. The association with other methodologies may produce more consistent data about body composition and its impact on fertility.

OC-125 immunostaining in endometriotic lesion samples.

PURPOSE: To determine the presence of OC-125 staining in endometriotic lesions and to verify whether there is an association with endometriosis stage. METHODS: Thirteen patients from the Family Planning programs (group I) and 53 patients from the Chronic Pelvic Pain outpatient clinic (group II) were studied. Endometriotic lesions were excised from areas of endometriosis incidence and studied by histopathological assay and by immunohistochemistry for OC-125 staining. RESULTS: The histopathological study disclosed that all patients from group I had minimal/mild endometriosis. In group II, 39.6% had minimal/mild endometriosis, and 60.4% had moderate/severe endometriosis. OC-125 staining was negative in all samples from group I. In group II, OC-125 staining was positive in 52.4% patients with minimal/mild endometriosis and in 81.2% with moderate/severe endometriosis. CONCLUSION: The data suggest that the OC-125 antibody is probably related to endometriosis activity and, consequently, to the progression and severity of the illness.

[Body mass index influence in female urinary incontinence]. / Influência do índice de massa corporal na incontinência urinária feminina.

PURPOSE: to evaluate and compare the effects of body mass index (BMI) on the severity of female urinary incontinence (UI) using the quality of life questionnaire King's Health Questionnaire (KHQ), variables of urodynamic studies and the medical history taken. METHODS: cross-sectional clinical study. We selected 65 patients with stress urinary incontinence (SUI) who were divided into three groups: Group I (BMI: 18-25 kg/m²), Group II (BMI: 25-30 kg/m²) and Group III (BMI>30 kg/m²). The KHQ domains were compared between these groups. In addition, some clinical history urodynamic data (presence of nocturia, enuresis, urgency and urge incontinence) were also related to BMI by calculating the Odds Ratio (OR). The BMI in the presence and absence of non-inhibited detrusor contractions and Valsalva leak point pressure (VLPP) <60 or > 60 cmH2O were evaluated. Finally, the correlation between BMI and the nine KHQ domains has been tested in order to detect some association. RESULTS: the KHQ did not record deterioration of quality of life in women with UI with increasing BMI in any of its areas. The OR for the presence of enuresis in relation to a BMI was 1.003 [CI: 0.897-1.121], p=0.962. The OR for nocturia was 1.049 [CI: 0.933-1.18], p=.425. The OR for urgency was 0.975 [CI: 0.826-1.151], p=0.762, and the OR for incontinence was 0.978 [CI: 0.85-1.126], p=0.76. We studied the BMI in patients with and without non-inhibited detrusor contractions and detected medians of 26.4 ± 4.8 and 28.3 ± 5.7 kg/m², respectively (p=0.6). Similarly, the median BMI values for the groups with VLPP <60 and >60 cmH2O were 29.6 ± 4.1 and 27.7 ± 5.7 kg/m², respectively (p=0.2). Finally, we failed to demonstrate an association between BMI and any of the nine KHQ domains by means of the Spearman correlation. CONCLUSION: there was no association of KHQ scores with BMI. There was also no correlation between the parameters of clinical history and of the urodynamic study with BMI.