The body mass index is the measurement of the amount of fat in an individual or, in other words, the ratio of body weight to height. In this way we determine normality in development, so that a BMI of less than 18.5 would indicate underweight. BMI between 18.5 and 24.9 would be in the normal or healthy range. Up to 30.0 we consider that we are in the overweight range and above 30.0 we would be dealing with obesity. Both underweight and overweight is an abnormal and undesirable situation and therefore has a negative influence on Artificial Insemination (AI).
Artificial insemination is a technique that facilitates pregnancy by depositing sperm - capacitated - into a woman's uterus when ovulation occurs. The normal development of the ovarian cycle, which will produce ovulation in the middle of the menstrual cycle, is closely linked to the proper homeostasis of the organism and hydrocarbon metabolism.
In this sense, alterations in the management of sugar and fat deposits alter this cycle, preventing normal ovulation, as, for example, in polycystic ovary syndrome (PCOS), which hinders the normal functioning of follicular maturation, preventing regular ovulation and, therefore, it is not possible to know in advance when ovulation is going to occur. Hence the need to harmonise the ovarian cycle in the case of a diabetic woman who is overweight. In the case of the male, being overweight and even more serious, obesity, can have a direct influence on the normal development of spermiogenesis, leading to a lower rate of recovery of motile sperm than that recommended for sperm capacitation for artificial insemination. In this situation, the most advisable technique for this type of patient would be IVF-ICSI.
Therefore, knowing these problems and in response to the question posed, BMI does have a negative influence, although per se, it does not prevent artificial insemination. It will ultimately depend on how this degree of overweight or obesity influences the ovarian cycle and whether or not this can be corrected with medication despite maintaining a high BMI. In the male, it will depend on sperm quality and the recovery of motile sperm in the ejaculate. In any situation, it should always be noted that obesity has a negative influence on oocyte quality and endometrial receptivity.
