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A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies.

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Title: A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies.
Authors: Purewal, Satvinder, Chapman, S. C. E., van den Akker, O. B. A
Source: Journal of Psychosomatic Obstetrics & Gynecology. Mar2019, Vol. 40 Issue 1, p2-18. 17p.
Subjects: Reproductive technology, Body mass index, Meta-analysis, Childbirth, Random effects model
Abstract: Objective: Lifestyle (smoking, drinking alcohol) and body mass index (BMI) predictors of successful outcomes in assisted reproductive technology (ART) treatments were examined in this meta-analysis.Method: A bibliographic search was undertaken using six databases. The review was informed by PRISMA/MOOSE guidelines. Meta-analytic data were analysed using random effects models.Results: We included 77 studies examining effects of BMI, smoking and drinking alcohol. Patients with a BMI< =24.9 were significantly more likely to achieve LB/pregnancy than with BMI> =25 OR = 1.219 (95% CI:1.128-1.319, z = 4.971, p < .001; I2 = 53.779%, p = .001). Non-smokers were significantly more likely to achieve a LB or pregnancy than smokers OR = 1.457 (95% CI:1.228-1.727, z = 4.324, p < .001; I2 = 51.883; p = .001). Meta-regression revealed the number of embryos transferred significantly moderated the effects of smoking on ART outcomes, and there was a trend indicating primary infertility and high BMI were also significant moderators. The evidence for drinking alcohol was inconclusive due to the small number of studies.Conclusions: This meta-analysis confirms that ART treatment success can be predicted with lifestyle factors. Further, non-smokers' relative odds of pregnancy/live birth increase as more embryos were transferred but there was a trend that the odds of pregnancy/live birth decrease with primary infertility and high BMI. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:<bold>Objective: </bold>Lifestyle (smoking, drinking alcohol) and body mass index (BMI) predictors of successful outcomes in assisted reproductive technology (ART) treatments were examined in this meta-analysis.<bold>Method: </bold>A bibliographic search was undertaken using six databases. The review was informed by PRISMA/MOOSE guidelines. Meta-analytic data were analysed using random effects models.<bold>Results: </bold>We included 77 studies examining effects of BMI, smoking and drinking alcohol. Patients with a BMI< =24.9 were significantly more likely to achieve LB/pregnancy than with BMI> =25 OR = 1.219 (95% CI:1.128-1.319, z = 4.971, p < .001; I2 = 53.779%, p = .001). Non-smokers were significantly more likely to achieve a LB or pregnancy than smokers OR = 1.457 (95% CI:1.228-1.727, z = 4.324, p < .001; I2 = 51.883; p = .001). Meta-regression revealed the number of embryos transferred significantly moderated the effects of smoking on ART outcomes, and there was a trend indicating primary infertility and high BMI were also significant moderators. The evidence for drinking alcohol was inconclusive due to the small number of studies.<bold>Conclusions: </bold>This meta-analysis confirms that ART treatment success can be predicted with lifestyle factors. Further, non-smokers' relative odds of pregnancy/live birth increase as more embryos were transferred but there was a trend that the odds of pregnancy/live birth decrease with primary infertility and high BMI. [ABSTRACT FROM AUTHOR]
ISSN:0167482X
DOI:10.1080/0167482X.2017.1403418