Abstract

Background: Excess adiposity has been associated with endocrine and metabolic alterations that may affect ovarian physiology and outcomes in assisted reproductive technology (ART). Objectives: The purpose of this study was to evaluate whether body mass index (BMI) was independently associated with ovarian follicular response in women undergoing assisted reproductive procedures. Methods: A cross-sectional study was conducted including 259 women aged 18 to 43 years. Analyses included nutritional status, diet quality, and follicular response. Associations were analyzed using chi-square and Kruskal–Wallis tests and negative binomial regression adjusted for age and indication. Results: Mean age was 32.8 ± 6.3 years, and mean BMI was 24.7 ± 3.2 kg/m2. Diet quality was not associated with follicle number or morphological quality. Overall, 47.5% of participants had normal weight, 42.9% were overweight, and 6.9% had class I obesity. Follicular yield differed across BMI categories in unadjusted analyses (p = 0.017), but BMI was not independently associated with follicle count after adjustment (IRR = 1.010; 95% CI: 0.983–1.036; p = 0.488). Age remained the only independent predictor, with each additional year associated with a 5.9% reduction in expected follicle count (IRR = 0.941; 95% CI: 0.920–0.963; p < 0.001). Conclusions: BMI was not independently associated with follicular yield after adjustment, whereas age remained the principal determinant of ovarian response. These findings should be confirmed in prospective studies incorporating ovarian reserve markers and stimulation-related variables.

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