{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:11:36Z","timestamp":1770351096085,"version":"3.49.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The increasing prevalence of obesity underscores the need to explore its impact on assisted reproductive technology (ART) outcomes. This study aims to evaluate the association between visceral fat area (VFA), measured by bioelectrical impedance analysis (BIA), and pregnancy outcomes following frozen embryo transfer (FET).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective clinical study, the data of 1,510 patients who underwent FET between April 2022 and April 2023 were analyzed. The VFA was measured by BIA, and patients were categorized into low and high VFA groups based on a threshold of 65 cm\u00b2. Pregnancy outcomes were compared between the two groups. Univariable and multivariate logistic regression analyses, along with restricted cubic spline (RCS) modeling, were used to adjust for age, body mass index (BMI), and basal estradiol (E2) levels to determine the relationship between VFA and FET outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were significant differences in baseline characteristics and outcomes between the two groups. The high VFA group was characterized by older age and a lower basal estradiol (E2) level. The biochemical pregnancy rate, implantation rate, clinical pregnancy rate (CPR), and live birth rate (LBR) were significantly lower in the high VFA group. Logistic regression revealed a significant negative correlation between the high VFA group and both CPR and LBR. The RCS model demonstrated that the VFA was nonlinearly correlated with CPR and LBR. Subgroup analysis showed that among individuals under 35 years of age or with a BMI &amp;lt; 24, high VFA was significantly associated with poorer CPR and LBR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High VFA is associated with poorer pregnancy outcomes after FET in female patients with infertility, with both CPR and LBR decreasing as VFA increases. Clinicians should consider VFA as an important reference for targeted fat management interventions to optimize reproductive success, especially when VFA exceeds 65 cm\u00b2.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2024.1474201","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T05:12:38Z","timestamp":1736485958000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the impact of visceral fat on the outcomes of frozen embryo transfer via bioelectrical impedance analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Danyu","family":"Ni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qijun","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaidi","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiufeng","family":"Ling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.120.007292","article-title":"Obesity prevalence and risks among Chinese adults: findings from the China PEACE million persons project, 2014-2018","volume":"14","author":"Mu","year":"2021","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.01.017","article-title":"Obesity and female infertility: potential mediators of obesity\u2019s impact","volume":"107","author":"Broughton","year":"2017","journal-title":"Fertil Steril"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154193","article-title":"The effect of excess body fat on female and male reproduction","volume":"107","author":"Mintziori","year":"2020","journal-title":"Metabolism"},{"key":"B4","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1097\/AOG.0b013e31821fd360","article-title":"Effect of obesity on oocyte and embryo quality in women undergoing in vitro fertilization","volume":"118","author":"Shah","year":"2011","journal-title":"Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000002992","article-title":"Association between body mass index and in vitro fertilization\/intra-cytoplasmic sperm injection outcomes: An analysis of 15,124 normal ovarian responders in China","volume":"137","author":"Zheng","year":"2024","journal-title":"Chin Med J (Engl)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead042","article-title":"The combined effect of BMI and age on ART outcomes","volume":"38","author":"Rafael","year":"2023","journal-title":"Hum Reprod"},{"key":"B7","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12916-023-03167-0","article-title":"Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes","volume":"22","author":"Borges","year":"2024","journal-title":"BMC Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1152\/physrev.00033.2011","article-title":"Pathophysiology of human visceral obesity: an update","volume":"93","author":"Tchernof","year":"2013","journal-title":"Physiol Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1014778","article-title":"Molecular tracking of insulin resistance and inflammation development on visceral adipose tissue","volume":"14","author":"Bensussen","year":"2023","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"144","DOI":"10.3390\/biology12020144","article-title":"First trimester evaluation of maternal visceral fat and its relationship with adverse pregnancy outcomes","volume":"12","author":"Brenes-Mart\u00edn","year":"2023","journal-title":"Biol (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.4158\/ep12331.Or","article-title":"Measuring visceral and hepatic fat in clinical practice and clinical research","volume":"19","author":"Naboush","year":"2013","journal-title":"Endocr Pract"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2010.71","article-title":"Validity of a new abdominal bioelectrical impedance device to measure abdominal and visceral fat: comparison with MRI","volume":"18","author":"Browning","year":"2010","journal-title":"Obes (Silver Spring)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.5551\/jat.11528","article-title":"The utility of visceral fat level by bioelectrical impedance analysis in the screening of metabolic syndrome - the results of the Kyushu and Okinawa Population Study (KOPS)","volume":"19","author":"Unno","year":"2012","journal-title":"J Atheroscler Thromb"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e06264","article-title":"Correlation of body visceral fat rating with serum lipid profile and fasting blood sugar in obese adults using a noninvasive machine","volume":"7","author":"Sukkriang","year":"2021","journal-title":"Heliyon"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10522-017-9693-9","article-title":"Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women","volume":"18","author":"Zaj\u0105c-Gawlak","year":"2017","journal-title":"Biogerontology"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del358","article-title":"Morphologic parameters of early cleavage-stage embryos that correlate with fetal development and delivery: prospective and applied data for increased pregnancy rates","volume":"22","author":"Scott","year":"2007","journal-title":"Hum Reprod"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/s0015-0282(00)00518-5","article-title":"Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer","volume":"73","author":"Gardner","year":"2000","journal-title":"Fertil Steril"},{"key":"B18","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.ejogrb.2005.12.009","article-title":"Obesity does not adversely affect results in patients who are undergoing in vitro fertilization and embryo transfer","volume":"127","author":"Dechaud","year":"2006","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/s1472-6483(10)60142-3","article-title":"Impact of body mass index on IVF and ICSI outcome: a retrospective study","volume":"16","author":"Matalliotakis","year":"2008","journal-title":"Reprod BioMed Online"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa010","article-title":"Female obesity does not impact live birth rate after frozen-thawed blastocyst transfer","volume":"35","author":"Prost","year":"2020","journal-title":"Hum Reprod"},{"key":"B21","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12916-019-1354-1","article-title":"Effect of body mass index on pregnancy outcomes in a freeze-all policy: an analysis of 22,043 first autologous frozen-thawed embryo transfer cycles in China","volume":"17","author":"Zhang","year":"2019","journal-title":"BMC Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz011","article-title":"Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis","volume":"25","author":"Sermondade","year":"2019","journal-title":"Hum Reprod Update"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.07.027","article-title":"Frozen embryo transfer outcomes decline with increasing female body mass index in female but not male factor infertility: analysis of 56,564 euploid blastocyst transfers","volume":"121","author":"Bakkensen","year":"2024","journal-title":"Fertil Steril"},{"key":"B24","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s12933-023-01876-7","article-title":"Normal-weight visceral obesity promotes a higher 10-year atherosclerotic cardiovascular disease risk in patients with type 2 diabetes mellitus-a multicenter study in China","volume":"22","author":"Zheng","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1144834","article-title":"Visceral fat correlates with insulin secretion and sensitivity independent of BMI and subcutaneous fat in Chinese with type 2 diabetes","volume":"14","author":"Huang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.02.036","article-title":"Does maternal age affect assisted reproduction technology success rates after euploid embryo transfer? A systematic review and meta-analysis","volume":"120","author":"Vitagliano","year":"2023","journal-title":"Fertil Steril"},{"key":"B27","doi-asserted-by":"publisher","first-page":"138.e131","DOI":"10.1016\/j.ajog.2019.03.011","article-title":"Influence of metabolic syndrome on female fertility and in vitro fertilization outcomes in PCOS women","volume":"221","author":"He","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.06.001","article-title":"Obesity reduces uterine receptivity: clinical experience from 9,587 first cycles of ovum donation with normal weight donors","volume":"100","author":"Bellver","year":"2013","journal-title":"Fertil Steril"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.12.032","article-title":"Female obesity impairs in vitro fertilization outcome without affecting embryo quality","volume":"93","author":"Bellver","year":"2010","journal-title":"Fertil Steril"},{"key":"B30","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1186\/s12916-022-02672-y","article-title":"Obese visceral fat tissue inflammation: from protective to detrimental","volume":"20","author":"Kolb","year":"2022","journal-title":"BMC Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.R086975","article-title":"Determinants of body fat distribution in humans may provide insight about obesity-related health risks","volume":"60","author":"Frank","year":"2019","journal-title":"J Lipid Res"},{"key":"B32","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/j.1478-3231.2008.01952.x","article-title":"Hepatitis C, insulin resistance and diabetes: clinical and pathogenic data","author":"Serfaty","year":"2009","journal-title":"Liver Int"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.1016\/j.fertnstert.2011.03.021","article-title":"Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome","volume":"95","author":"Bellver","year":"2011","journal-title":"Fertil Steril"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1474201\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T05:12:41Z","timestamp":1736485961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2024.1474201\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,10]]},"references-count":33,"alternative-id":["10.3389\/fendo.2024.1474201"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2024.1474201","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,10]]},"article-number":"1474201"}}