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Abstract
Obesity is a rising health problem worldwide. It has been related to increased morbidity and mortality rates due to several pathologies .Unfortunately, for over 100 years, the incidence of obesity has been increasing in both developed and developing countries, In Egypt the demographic data revealed that among ever married women the prevalence of obesity was 46.6 % and overweight was 33.1 %
It is a chronic multifactorial disease in which Both environmental and genetic factors are involved in complex interaction of variables, include psychological, cultural and physiological regulatory mechanisms . Obesity OCCtlfS when caloric intake exceeds caloric expenditure. and it is described as an abnormal accumulation of fat in the adipose tissue. It is a major health hazard and is associated with several relatively common diseases such as diabetes, hypertension, heart disease, and some cancers (as breast colon, endometrial ).
A number of methods are used to determine obesity. Some of them are based on mathematical calculations of the relation between height and weight as Body Mass Index that is calculated by dividing a person’s weight in kilograms by height in meters squared. The World Health Organization (WHO) identify obesity as a BMI of 30 kg/m2 or greater. Other methods are based on measurements of body fat content which is the most variable component of the body differing among individuals of the same sex, height, and weight and it is measured by bioelectrical impendence
Obesity is known to impair human reproduction and it is associated with menstrual disorders, hirsutism, infertility, miscarriage, and obstetric complications through different mechanisms such as insulin resistance, hyperandrogenism, and elevated leptin levels.
Although the incidence of infertility (defined as inability to conceive after one year of regular unprotected intercourse ) has not changed over the last few decades, the ability to help infertile couples to achieve pregnancy has significantly increased mainly due to the introduction of assisted reproductive technology (ART), notably In Vitro Fertilization (IVF) and Intra-cytoplasmic Sperm Injection (ICSI). The evidence for the impact of obesity on pregnancy rates after ICSI is conflicting with some studies confirming its harmful effect while others did not support this harmful effect. Thus the aim of the present study was to assess the impact of obesity on ICSI program outcomes among infertile women attending assisted reproductive center in a prospective cohort design.
The study was conducted upon 220 infertile females aged from 20 -35 years indicated for ICSI treatment that were divided into two groups each one contains 110 females according to BMI value ( <25 kg/m2 and >25kg/m2).
Pre -designed interview questionnaire to collect data including personal ,medical obstetric and gynaecological histories was fulfilled to all females then complete examination and investigations were done to detect the etiology of infertility in the studied females. All females were subjected to long agonist orotocol of ovarian induction with oocyte retrival 34-36 hours after HCG injection and embryo transfer after 48 hours of fertilization.