Weight gain after in vitro fertilization: a potential consequence of controlled ovarian stimulation

Abstract

In the USA, 42% of adult women were estimated to have obesity, and 13% of women of childbearing age similarly have impaired fecundity. Obesity is associated with infertility such that patients with obesity often seek out in vitro fertilization (IVF) services. Here, we report on the case of a woman with childhood-onset class II obesity who had been undergoing treatment with phentermine and topiramate prior to undergoing 3 cycles of IVF. With each cycle, the patient temporarily gained 13-15 lbs. during controlled ovarian stimulation (COS). Weight gain from COS may be clinically relevant and merits further study to optimize weight status across women's reproductive life and to better assist women who gain weight secondary to IVF. Incorporating weight monitoring into IVF protocols may also help better characterize the scope of weight gain from COS.

Fig. 1

Weight management following presentation at Massachusetts General Hospital (MGH) Weight Center (blue arrow) in late 2011 with initiation of phentermine (green arrow) and topiramate (purple arrow) shown. Pharmacotherapy was terminated in early 2014 (orange arrow) due to contraindication with pregnancy

Fig. 2

A Weight trends are demonstrated in the 12 months prior to the first cycle, in the month when the first cycle ovarian stimulation medications were received, and in the first trimester of pregnancy of the first cycle. B Weight trends are demonstrated in the 12 months prior to the second cycle, in the month when the second cycle ovarian stimulation medications were received, during the 4-month interlude between the second and third cycles, in the month when the third cycle ovarian stimulation medications were received, and in the first trimester of pregnancy of the third cycle. Anti-obesity medications were terminated prior to initiating all the three cycles. Red dotted lines demark the period when ovarian stimulation medications are received