Effect of Orlistat on Live Birth Rate in Overweight or Obese Women Undergoing IVF-ET: A Randomized Clinical Trial

Abstract Context Obesity management prior to infertility treatment remains a challenge. To date, results from randomized clinical trials involving weight loss by lifestyle interventions have shown no evidence of improved live birth rate. Objective This work aimed to determine whether pharmacologic w...

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Published in:The journal of clinical endocrinology and metabolism 2021-09, Vol.106 (9), p.e3533-e3545
Main Authors: Wang, Ze, Zhao, Junli, Ma, Xiang, Sun, Yun, Hao, Guimin, Yang, Aijun, Ren, Wenchao, Jin, Lei, Lu, Qun, Wu, Gengxiang, Ling, Xiufeng, Hao, Cuifang, Zhang, Bo, Liu, Xinyu, Yang, Dongzi, Zhu, Yimin, Li, Jing, Bao, Hongchu, Wang, Ancong, Liu, Jianqiao, Chen, Zi-Jiang, Tan, Jichun, Shi, Yuhua
Format: Article
Language:English
Subjects:
Birth rate
Birth weight
Body mass index
Body weight
Body weight loss
Clinical trials
Embryo transfer
Embryonic development
Fertilization in vitro
Hypoglycemic agents
In vitro fertilization
Infertility
Obesity
Orlistat
Overweight
Placebos
Pregnancy
Product development
Statistical analysis
Weight control
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Summary:Abstract Context Obesity management prior to infertility treatment remains a challenge. To date, results from randomized clinical trials involving weight loss by lifestyle interventions have shown no evidence of improved live birth rate. Objective This work aimed to determine whether pharmacologic weight-loss intervention before in vitro fertilization and embryo transfer (IVF-ET) can improve live birth rate among overweight or obese women. Methods We conducted a randomized, double-blinded, placebo-controlled trial across 19 reproductive medical centers in China, from July 2017 to January 2019. A total of 877 infertile women scheduled for IVF who had a body mass index of 25 or greater were randomly assigned to receive orlistat (n = 439) or placebo (n = 438) treatment for 4 to 12 weeks. The main outcome measurement was the live birth rate after fresh ET. Results The live birth rate was not significantly different between the 2 groups (112 of 439 [25.5%] with orlistat and 112 of 438 [25.6%] with placebo; P = .984). No significant differences existed between the groups as to the rates of conception, clinical pregnancy, or pregnancy loss. A statistically significant increase in singleton birth weight was observed after orlistat treatment (3487.50 g vs 3285.17 g in the placebo group; P = .039). The mean change in body weight during the intervention was −2.49 kg in the orlistat group, as compared to −1.22 kg in the placebo group, with a significant difference (P = .005). Conclusion Orlistat treatment, prior to IVF-ET, did not improve the live birth rate among overweight or obese women, although it was beneficial for weight reduction.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgab340