Effect of female body mass index on intrauterine insemination outcomes: a systematic review and meta-analysis

Abstract

The prevalence of women with a raised body mass index (BMI) seeking assisted conception treatment is increasing. Findings of existing studies evaluating the effect of female BMI on intrauterine insemination (IUI) treatment outcomes remain inconsistent. This systematic review and meta-analysis evaluate the effect of female BMI on IUI treatment outcomes. Two authors independently conducted data extraction and assessed study quality. Risk ratios (RR) and 95% confidence intervals were calculated using the Mantel-Haenszel approach for dichotomous outcomes. 11 studies involving 23,145 IUI treatment events, comprising 21,211 cycles from 8 studies, and 1,934 participants in three studies, met the inclusion criteria for the meta-analysis. Two cohorts of women undergoing IUI treatment were compared - women with normal BMI < 25 kg/m² were compared with a second cohort of women with a BMI category ≥ 25 kg/m². There was no statistically significant difference in live birth rate (LBR) (RR 1.06, 95% CI 0.86–1.307); clinical pregnancy rate (CPR) (RR 0.94, 95% CI 0.78–1.13); miscarriage (RR 0.92, 95% CI 0.31–2.74) or ectopic pregnancy rate (RR 2.20, 95% CI 0.78–6.23). Our meta-analysis showed that a raised female BMI did not affect IUI treatment outcomes. Nevertheless, weight loss counselling should be offered to women with a raised BMI undergoing IUI, to reduce the associated obstetric morbidity.

TWEETABLE ABSTRACT

A meta-analysis of 11 studies found that having a raised female BMI did not change IUI treatment outcomes.

Keywords:

• BMI
• iUI
• clinical pregnancy
• livebirth
• systematic review
• meta-analysis

Acknowledgements

The authors would like to express their gratitude to Leorita Henry, Clinical Support Librarian at King’s College Hospital for her help in conducting the search.

Ethical approval

None required

Authors’ contribution

SKS conceived the idea. VS and HK performed data collection, tabulated data and analysis. VS and MSK performed statistical analysis. VS, HK, FB, YB, IS, MSK and SKS contributed to writing the manuscript and approved of the final version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

None received